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1063831550 NPI number — JILL PUTNAM MD

NPI Number: 1063831550
Health Care Provider/Practitioner: JILL PUTNAM MD

Information about “1063831550” NPI (JILL PUTNAM MD) exists in 1063831550 in HTML format HTML  |  1063831550 in plain Text format TXT  |  1063831550 in PDF (Portable Document Format) PDF  |  1063831550 in an XML format XML  formats.

NPI Number : 1063831550 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1063831550",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "PUTNAM",
    "FirstName": "JILL",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "MD",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "195 EASTERN BLVD STE 200",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "GLASTONBURY",
    "MailingAddressStateName": "CT",
    "MailingAddressPostalCode": "06033-4353",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "614-893-8800",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "195 EASTERN BLVD STE 200",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "GLASTONBURY",
    "PracticeLocationAddressStateName": "CT",
    "PracticeLocationAddressPostalCode": "06033-4353",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "614-893-8800",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "04/10/2014",
    "LastUpdateDate": "01/07/2022",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "207X00000X",
          "TaxonomyName": "Orthopaedic Surgery Physician",
          "LicenseNumber": "64931",
          "LicenseNumberStateCode": "CT",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "390200000X",
          "TaxonomyName": "Student in an Organized Health Care Education/Training Program",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "2086S0105X",
          "TaxonomyName": "Surgery of the Hand (Surgery) Physician",
          "LicenseNumber": "64931",
          "LicenseNumberStateCode": "CT",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": {
        "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."
      }
    }
  }
}
                
            

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