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1083949531 NPI number — MARIO E ROXAS N.D.

NPI Number: 1083949531
Health Care Provider/Practitioner: MARIO E ROXAS N.D.

Information about “1083949531” NPI (MARIO E ROXAS N.D.) exists in 1083949531 in HTML format HTML  |  1083949531 in plain Text format TXT  |  1083949531 in PDF (Portable Document Format) PDF  |  1083949531 in an XML format XML  formats.

NPI Number : 1083949531 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1083949531",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "ROXAS",
    "FirstName": "MARIO",
    "MiddleName": "E",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "N.D.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "ROXAS",
    "OtherFirstName": "MARION",
    "OtherMiddleName": "E",
    "OtherNamePrefix": "DR.",
    "OtherNameSuffix": null,
    "OtherCredential": "N.D.",
    "OtherLastNameTypeCode": "5",
    "FirstLineMailingAddress": "1501 PONDEROSA DR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "SANDPOINT",
    "MailingAddressStateName": "ID",
    "MailingAddressPostalCode": "83864-8280",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "208-946-0984",
    "MailingAddressFaxNumber": "208-246-4995",
    "FirstLinePracticeLocationAddress": "476864 HIGHWAY 95",
    "SecondLinePracticeLocationAddress": "SUITE #3",
    "PracticeLocationAddressCityName": "PONDERAY",
    "PracticeLocationAddressStateName": "ID",
    "PracticeLocationAddressPostalCode": "83852-5000",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "208-946-0984",
    "PracticeLocationAddressFaxNumber": "208-246-4995",
    "EnumerationDate": "10/15/2009",
    "LastUpdateDate": "10/15/2009",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "175F00000X",
          "TaxonomyName": "Naturopath",
          "LicenseNumber": "0982",
          "LicenseNumberStateCode": "OR",
          "PrimaryTaxonomySwitch": "Y"
        },
        {
          "TaxonomyCode": "175F00000X",
          "TaxonomyName": "Naturopath",
          "LicenseNumber": "NT00001638",
          "LicenseNumberStateCode": "WA",
          "PrimaryTaxonomySwitch": "N"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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