{
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"FirstLineMailingAddress": "6300 MAIN ST",
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"MailingAddressCityName": "ZACHARY",
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"MailingAddressCountryCode": "US",
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"FirstLinePracticeLocationAddress": "2335 CHURCH ST STE B",
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"EnumerationDate": "04/19/2007",
"LastUpdateDate": "03/11/2025",
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "CORCORAN",
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"AuthorizedOfficialTelephoneNumber": "225-658-4303",
"Taxonomies": {
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"PrimaryTaxonomySwitch": "Y"
}
},
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}
}
}
}