{
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"EIN": null,
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"IsOrgSubpart": "N",
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"OrgName": "JOE E JOHNSON, JR MD APMC",
"LastName": null,
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"FirstLineMailingAddress": "PO BOX 1855",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MANDEVILLE",
"MailingAddressStateName": "LA",
"MailingAddressPostalCode": "70470-1855",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "985-893-9251",
"MailingAddressFaxNumber": "985-892-7893",
"FirstLinePracticeLocationAddress": "5001 HIGHWAY 190 EAST SERVICE RD",
"SecondLinePracticeLocationAddress": "SUITE A3",
"PracticeLocationAddressCityName": "COVINGTON",
"PracticeLocationAddressStateName": "LA",
"PracticeLocationAddressPostalCode": "70433-4930",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "985-893-9251",
"PracticeLocationAddressFaxNumber": "985-892-7893",
"EnumerationDate": "09/06/2006",
"LastUpdateDate": "04/01/2014",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "JOHNSON",
"AuthorizedOfficialFirstName": "JOE",
"AuthorizedOfficialMiddleName": "E",
"AuthorizedOfficialTitle": "MD",
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"AuthorizedOfficialNameSuffix": "JR.",
"AuthorizedOfficialCredential": "MD",
"AuthorizedOfficialTelephoneNumber": "985-893-9251",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "207R00000X",
"TaxonomyName": "Internal Medicine Physician",
"LicenseNumber": "019902",
"LicenseNumberStateCode": "LA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}