{
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"EIN": null,
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"OrgName": "JAMES R ANGEL MD PLLC",
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"FirstLineMailingAddress": "1698 OLD LEBANON RD",
"SecondLineMailingAddress": "SUITE 3B",
"MailingAddressCityName": "CAMPBELLSVILLE",
"MailingAddressStateName": "KY",
"MailingAddressPostalCode": "42718-9662",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "270-789-2471",
"MailingAddressFaxNumber": "270-465-4669",
"FirstLinePracticeLocationAddress": "1698 OLD LEBANON RD",
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"PracticeLocationAddressStateName": "KY",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "270-789-2471",
"PracticeLocationAddressFaxNumber": "270-465-4669",
"EnumerationDate": "11/16/2006",
"LastUpdateDate": "04/21/2009",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ANGEL",
"AuthorizedOfficialFirstName": "JAMES",
"AuthorizedOfficialMiddleName": "RAYMOND",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "MR.",
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"AuthorizedOfficialCredential": "MD",
"AuthorizedOfficialTelephoneNumber": "270-789-2471",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Urology Physician",
"LicenseNumber": "20672",
"LicenseNumberStateCode": "KY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
}
}
}
}