NPI Code Detail JSON Logo

1003558610 NPI number — ERIC A DARDEN JR. SGT

NPI Number: 1003558610
Health Care Provider/Practitioner: ERIC A DARDEN JR. SGT

Information about “1003558610” NPI (ERIC A DARDEN JR. SGT) exists in 1003558610 in HTML format HTML  |  1003558610 in plain Text format TXT  |  1003558610 in PDF (Portable Document Format) PDF  |  1003558610 in an XML format XML  formats.

NPI Number : 1003558610 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1003558610",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "DARDEN",
    "FirstName": "ERIC",
    "MiddleName": "A",
    "NamePrefix": null,
    "NameSuffix": "JR.",
    "Credential": "SGT",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "1430 ST STE 400",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "SAINT LOUIS",
    "MailingAddressStateName": "MO",
    "MailingAddressPostalCode": "63103",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "314-788-0185",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "1400 OLIVE",
    "SecondLinePracticeLocationAddress": "1430 OLIVE 400 STE",
    "PracticeLocationAddressCityName": "SAINT LOUIS",
    "PracticeLocationAddressStateName": "MO",
    "PracticeLocationAddressPostalCode": "63103",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "314-206-3700",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "04/13/2022",
    "LastUpdateDate": "04/13/2022",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "171000000X",
        "TaxonomyName": "Military Health Care Provider",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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