{
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "INFECTIOUS DISEASE PHYSICIANS OF DAYTON LLC",
"LastName": null,
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"NamePrefix": null,
"NameSuffix": null,
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"FirstLineMailingAddress": "PO BOX 652",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SPRINGBORO",
"MailingAddressStateName": "OH",
"MailingAddressPostalCode": "45066-0652",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "937-885-0464",
"MailingAddressFaxNumber": "937-885-0464",
"FirstLinePracticeLocationAddress": "9000 N MAIN ST",
"SecondLinePracticeLocationAddress": "INFUSION SERVICES",
"PracticeLocationAddressCityName": "DAYTON",
"PracticeLocationAddressStateName": "OH",
"PracticeLocationAddressPostalCode": "45415-1180",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "937-279-5803",
"PracticeLocationAddressFaxNumber": "937-279-5873",
"EnumerationDate": "12/14/2010",
"LastUpdateDate": "03/08/2011",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SORG",
"AuthorizedOfficialFirstName": "TIMOTHY",
"AuthorizedOfficialMiddleName": "B.",
"AuthorizedOfficialTitle": "SOLE PROPRIETOR",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "M.D.",
"AuthorizedOfficialTelephoneNumber": "937-885-0464",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "207RI0200X",
"TaxonomyName": "Infectious Disease Physician",
"LicenseNumber": "35-05-3064",
"LicenseNumberStateCode": "OH",
"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."
}
}
}
}