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1255564449 NPI number — ANDREW EVANS PAXSON PHARMD

NPI Number: 1255564449
Health Care Provider/Practitioner: ANDREW EVANS PAXSON PHARMD

Information about “1255564449” NPI (ANDREW EVANS PAXSON PHARMD) exists in 1255564449 in HTML format HTML  |  1255564449 in plain Text format TXT  |  1255564449 in PDF (Portable Document Format) PDF  |  1255564449 in an XML format XML  formats.

NPI Number : 1255564449 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1255564449",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "PAXSON",
    "FirstName": "ANDREW",
    "MiddleName": "EVANS",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "PHARMD",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "1704 E MAIN ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "COTTAGE GROVE",
    "MailingAddressStateName": "OR",
    "MailingAddressPostalCode": "97424-2244",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "541-942-2224",
    "MailingAddressFaxNumber": "541-942-8274",
    "FirstLinePracticeLocationAddress": "1704 E MAIN ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "COTTAGE GROVE",
    "PracticeLocationAddressStateName": "OR",
    "PracticeLocationAddressPostalCode": "97424-2244",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "541-942-2224",
    "PracticeLocationAddressFaxNumber": "541-942-8274",
    "EnumerationDate": "09/03/2009",
    "LastUpdateDate": "09/03/2009",
    "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": "183500000X",
        "TaxonomyName": "Pharmacist",
        "LicenseNumber": "RPH-0011178",
        "LicenseNumberStateCode": "OR",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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