{
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"EIN": null,
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"OrgName": "PRIMARY CARE CLINICS OF GEORGIA",
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"FirstLineMailingAddress": "1240 JESSE JEWELL PKWY SE",
"SecondLineMailingAddress": "SUITE 370",
"MailingAddressCityName": "GAINESVILLE",
"MailingAddressStateName": "GA",
"MailingAddressPostalCode": "30501-3861",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "770-536-1004",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1240 JESSE JEWELL PKWY SE",
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"PracticeLocationAddressCityName": "GAINESVILLE",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "770-536-1004",
"PracticeLocationAddressFaxNumber": "770-536-0905",
"EnumerationDate": "05/19/2006",
"LastUpdateDate": "07/21/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "HOCKER",
"AuthorizedOfficialFirstName": "DAVID",
"AuthorizedOfficialMiddleName": "LEON",
"AuthorizedOfficialTitle": "MEDICAL DIRECTOR",
"AuthorizedOfficialNamePrefix": "DR.",
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"AuthorizedOfficialCredential": "M.D., M.R.O.",
"AuthorizedOfficialTelephoneNumber": "770-536-1004",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Family Medicine Physician",
"LicenseNumber": "041138",
"LicenseNumberStateCode": "GA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}