{
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"FirstLineMailingAddress": "1201 GRAMPIAN BLVD",
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"MailingAddressCityName": "WILLIAMSPORT",
"MailingAddressStateName": "PA",
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"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1100 GRAMPIAN BLVD",
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"PracticeLocationAddressStateName": "PA",
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"PracticeLocationAddressTelephoneNumber": "570-320-7848",
"PracticeLocationAddressFaxNumber": "570-320-7856",
"EnumerationDate": "06/29/2006",
"LastUpdateDate": "10/20/2015",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "DAVIS",
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"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "570-320-7696",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Endocrinology, Diabetes & Metabolism Physician",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"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."
}
}
}
}