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General NPI Number Information
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NPI Number | 1881648830
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Entity Type | Individual
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Provider Name | WILLIAM JOSEPH MCCREIGHT III MD
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Gender | Male
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Dates
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Enumeration Date | 05/22/2006
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Last Update Date | 11/16/2011
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Provider Practice Location Address
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Address Line | 4701 W GATE BLVD STE D404
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City | AUSTIN
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State | TX
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Zip | 78745-1467
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Country | US
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Telephone | 512-899-8300
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Fax | 512-899-8307
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Provider Business Mailing Address
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Address Line | 3210 SESBANIA DR
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City | AUSTIN
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State | TX
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Zip | 78748-2632
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Country | US
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Telephone | 512-569-5870
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Fax | 512-899-8307
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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 | J4337
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License Number State | TX
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