NPI Code Detail JSON Logo

1073603544 NPI number — AGATA J VOLLERS MD

NPI Number: 1073603544
Health Care Provider/Practitioner: AGATA J VOLLERS MD

Information about “1073603544” NPI (AGATA J VOLLERS MD) exists in 1073603544 in HTML format HTML  |  1073603544 in plain Text format TXT  |  1073603544 in PDF (Portable Document Format) PDF  |  1073603544 in an XML format XML  formats.

NPI Number : 1073603544 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1073603544",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "VOLLERS",
    "FirstName": "AGATA",
    "MiddleName": "J",
    "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": "2995 DREW ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "CLEARWATER",
    "MailingAddressStateName": "FL",
    "MailingAddressPostalCode": "33759-3012",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "727-315-7496",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "920 STANTON L YOUNG BLVD STE 1140",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "OKLAHOMA CITY",
    "PracticeLocationAddressStateName": "OK",
    "PracticeLocationAddressPostalCode": "73104-5036",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "405-271-4351",
    "PracticeLocationAddressFaxNumber": "405-271-8665",
    "EnumerationDate": "10/13/2006",
    "LastUpdateDate": "12/16/2025",
    "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": "207L00000X",
          "TaxonomyName": "Anesthesiology Physician",
          "LicenseNumber": "E-3838",
          "LicenseNumberStateCode": "AR",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207L00000X",
          "TaxonomyName": "Anesthesiology Physician",
          "LicenseNumber": "V8551",
          "LicenseNumberStateCode": "TX",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207L00000X",
          "TaxonomyName": "Anesthesiology Physician",
          "LicenseNumber": "ME174291",
          "LicenseNumberStateCode": "FL",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207L00000X",
          "TaxonomyName": "Anesthesiology Physician",
          "LicenseNumber": "46530",
          "LicenseNumberStateCode": "OK",
          "PrimaryTaxonomySwitch": "Y"
        },
        {
          "TaxonomyCode": "207L00000X",
          "TaxonomyName": "Anesthesiology Physician",
          "LicenseNumber": "14999",
          "LicenseNumberStateCode": "NV",
          "PrimaryTaxonomySwitch": "N"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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