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General NPI Number Information
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NPI Number | 1598864233
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Entity Type | Individual
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Provider Name | JULIE R LYNCH DO
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Gender | Female
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Dates
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Enumeration Date | 09/21/2006
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Last Update Date | 09/06/2016
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Provider Practice Location Address
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Address Line | 312 S 7TH ST SUITE 4
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City | DELAVAN
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State | WI
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Zip | 53115-1964
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Country | US
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Telephone | 262-740-0900
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Fax | 262-740-0909
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Provider Business Mailing Address
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Address Line | 14780 W MOUNTAIN VIEW BLVD STE 110
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City | SURPRISE
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State | AZ
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Zip | 85374-7280
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Country | US
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Telephone | 262-740-0900
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Fax | 262-740-0909
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 44907-021
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License Number State | WI
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