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General NPI Number Information
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NPI Number | 1750737979
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Entity Type | Individual
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Provider Name | PATRICK ALEXANDER WILLIAMSON O.D.
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Gender | Male
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Dates
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Enumeration Date | 05/05/2016
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Last Update Date | 07/26/2022
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Provider Practice Location Address
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Address Line | 420 CENTER AVE STE 41
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City | MOORHEAD
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State | MN
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Zip | 56560-1962
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Country | US
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Telephone | 218-233-1624
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Fax | 218-233-2058
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Provider Business Mailing Address
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Address Line | 420 CENTER AVE STE 41
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City | MOORHEAD
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State | MN
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Zip | 56560-1962
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Country | US
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Telephone | 218-233-1624
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Fax | 218-233-2058
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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 | 748
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License Number State | ND
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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 | 3478
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License Number State | MN
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