{
"Npi": {
"NPI": "1174613640",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "WOLOSZYN",
"FirstName": "TOMASZ",
"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": "1805 PARKCHESTER DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "LAS VEGAS",
"MailingAddressStateName": "NV",
"MailingAddressPostalCode": "89108-2007",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "702-767-0297",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "4700 LAS VEGAS BLVD N",
"SecondLinePracticeLocationAddress": "SUITE 3-3344",
"PracticeLocationAddressCityName": "NELLIS AFB",
"PracticeLocationAddressStateName": "NV",
"PracticeLocationAddressPostalCode": "89191-6600",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "702-653-1110",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "10/13/2006",
"LastUpdateDate": "11/21/2016",
"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": "207L00000X",
"TaxonomyName": "Anesthesiology Physician",
"LicenseNumber": "E-2980",
"LicenseNumberStateCode": "AR",
"PrimaryTaxonomySwitch": "Y"
},
{
"TaxonomyCode": "207L00000X",
"TaxonomyName": "Anesthesiology Physician",
"LicenseNumber": "01054289A",
"LicenseNumberStateCode": "IN",
"PrimaryTaxonomySwitch": "N"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}