{
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"FirstLineMailingAddress": "1011 S MOUNT CARMEL PL",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "PITTSBURG",
"MailingAddressStateName": "KS",
"MailingAddressPostalCode": "66762-6604",
"MailingAddressCountryCode": "US",
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"MailingAddressFaxNumber": "620-231-1378",
"FirstLinePracticeLocationAddress": "1011 S MOUNT CARMEL PL",
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"PracticeLocationAddressCityName": "PITTSBURG",
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"PracticeLocationAddressTelephoneNumber": "620-232-2270",
"PracticeLocationAddressFaxNumber": "620-231-1378",
"EnumerationDate": "10/06/2006",
"LastUpdateDate": "08/22/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "WHITE",
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"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Psychiatry Physician",
"LicenseNumber": "05-16917",
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}
},
"HealthcareProviderTaxonomyGroups": {
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"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}