{
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"FirstLineMailingAddress": "350 N HUMPHREYS BLVD",
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"MailingAddressCountryCode": "US",
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"FirstLinePracticeLocationAddress": "363 SOUTHCREST CIR STE 102",
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"PracticeLocationAddressCityName": "SOUTHAVEN",
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"EnumerationDate": "07/29/2022",
"LastUpdateDate": "07/29/2022",
"NPIDeactivationReasonCode": null,
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"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "DUCKETT",
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"Taxonomies": {
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"PrimaryTaxonomySwitch": "Y"
}
},
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}
}