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General NPI Number Information
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NPI Number | 1780680660
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Entity Type | Individual
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Provider Name | WILLIAM E GOTTLIEB M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/24/2005
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Last Update Date | 02/14/2008
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Provider Practice Location Address
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Address Line | 360 PEAK ONE DRIVE STE 180
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City | FRISCO
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State | CO
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Zip | 80443
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Country | US
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Telephone | 970-668-3633
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Fax | 970-668-4406
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Provider Business Mailing Address
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Address Line | PO BOX 1921
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City | ENGLEWOOD
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State | CO
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Zip | 80150-1921
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Country | US
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Telephone | 970-241-0202
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Fax | 970-245-0250
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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 | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number | 30280
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License Number State | CO
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