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General NPI Number Information
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NPI Number | 1740017235
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Entity Type | Individual
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Provider Name | MADISON HAYLEY GROSS OD
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Gender | Female
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Dates
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Enumeration Date | 09/18/2024
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Last Update Date | 07/28/2025
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Provider Practice Location Address
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Address Line | 620B MAIN ST
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City | FRISCO
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State | CO
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Zip | 80443-5487
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Country | US
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Telephone | 970-668-2020
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Fax | 970-668-0912
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Provider Business Mailing Address
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Address Line | PO BOX 583
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City | FRISCO
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State | CO
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Zip | 80443-0583
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Country | US
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Telephone | 970-668-2020
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Fax | 970-668-0912
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 046-011923
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPT.0004100
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License Number State | CO
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