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General NPI Number Information
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NPI Number | 1942838420
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Entity Type | Individual
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Provider Name | ABIGAIL JUNE WILLIAMS PA-C
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Gender | Female
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Dates
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Enumeration Date | 03/30/2020
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Last Update Date | 11/02/2021
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Provider Practice Location Address
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Address Line | 112 PIPER HILL DR STE 9
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City | SAINT PETERS
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State | MO
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Zip | 63376-1690
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Country | US
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Telephone | 636-229-4239
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Fax | 636-441-9832
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Provider Business Mailing Address
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Address Line | 11844 SMOKE VALLEY CT
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City | MARYLAND HEIGHTS
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State | MO
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Zip | 63043-1634
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Country | US
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Telephone | 217-257-9111
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Fax |
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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