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General NPI Number Information
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NPI Number | 1538153127
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Entity Type | Individual
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Provider Name | JAMES ALLEN WILLIS M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/09/2005
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Last Update Date | 05/14/2014
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Provider Practice Location Address
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Address Line | 11971 HERITAGE OAK PL
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City | AUBURN
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State | CA
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Zip | 95603-2461
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Country | US
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Telephone | 530-745-9615
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Fax | 530-745-9610
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Provider Business Mailing Address
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Address Line | 11971 HERITAGE OAK PL
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City | AUBURN
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State | CA
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Zip | 95603-2461
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Country | US
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Telephone | 530-745-9615
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Fax | 530-745-9610
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | G37443
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License Number State | CA
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