{
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"IsOrgSubpart": "N",
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"OrgName": "EAST COBB URGENT CARE, LLC",
"LastName": null,
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"NamePrefix": null,
"NameSuffix": null,
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"FirstLineMailingAddress": "1445 ROSS AVE",
"SecondLineMailingAddress": "SUITE 1400",
"MailingAddressCityName": "DALLAS",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "75202-2711",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "770-971-5494",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1401 JOHNSON FERRY RD",
"SecondLinePracticeLocationAddress": "SUITE 390",
"PracticeLocationAddressCityName": "MARIETTA",
"PracticeLocationAddressStateName": "GA",
"PracticeLocationAddressPostalCode": "30062-6495",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "770-971-5494",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "02/14/2007",
"LastUpdateDate": "05/26/2016",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BURTNETT",
"AuthorizedOfficialFirstName": "MICHAEL",
"AuthorizedOfficialMiddleName": "KYLE",
"AuthorizedOfficialTitle": "SVP OF OUTPATIENT SERVICES, TENET",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "469-893-2153",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QU0200X",
"TaxonomyName": "Urgent Care Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": "GA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}