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General NPI Number Information
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NPI Number | 1710266598
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Entity Type | Organization
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Legal Business Name | COLORADO ANESTHESIA GROUP PLLC
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Dates
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Enumeration Date | 08/10/2011
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Last Update Date | 09/08/2016
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Provider Practice Location Address
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Address Line | 181 W MEADOW DR
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City | VAIL
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State | CO
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Zip | 81657-5242
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Country | US
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Telephone | 970-476-2451
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Fax | 770-874-5483
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Provider Business Mailing Address
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Address Line | 5665 NEW NORTHSIDE DR NW SUITE 320
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City | ATLANTA
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State | GA
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Zip | 30328-5831
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Country | US
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Telephone | 770-874-5400
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Fax | 770-874-5483
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Authorized Official
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Title or Position | CHIEF REVENUE OFFICER
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Name | MR. PRESTON WILLIAMS SMITH
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Credential |
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Telephone | 770-874-5400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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