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General NPI Number Information
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NPI Number | 1962626572
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Entity Type | Individual
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Provider Name | KATHRYN K WILLIFORD M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/13/2007
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Last Update Date | 03/20/2025
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Provider Practice Location Address
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Address Line | 2011 WESTEND DR
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City | GREENSBORO
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State | GA
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Zip | 30642-5146
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Country | US
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Telephone | 706-453-9803
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Fax | 706-453-0728
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Provider Business Mailing Address
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Address Line | 2467 GOLDEN CAMP RD
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City | AUGUSTA
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State | GA
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Zip | 30906-5515
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Country | US
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Telephone | 706-790-4440
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Fax | 706-922-0252
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 040114
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License Number State | GA
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