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1265629729 NPI number — LARRY L WASHBURN O.D.

NPI Number: 1265629729
Health Care Provider/Practitioner: LARRY L WASHBURN O.D.

Information about “1265629729” NPI (LARRY L WASHBURN O.D.) exists in 1265629729 in HTML format HTML  |  1265629729 in plain Text format TXT  |  1265629729 in PDF (Portable Document Format) PDF  |  1265629729 in an XML format XML  formats.

NPI Number : 1265629729 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1265629729",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "WASHBURN",
    "FirstName": "LARRY",
    "MiddleName": "L",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "O.D.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "PO BOX 747",
    "SecondLineMailingAddress": "505 N FRANKLIN AVE",
    "MailingAddressCityName": "COLBY",
    "MailingAddressStateName": "KS",
    "MailingAddressPostalCode": "67701-0747",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "785-462-3348",
    "MailingAddressFaxNumber": "785-462-3599",
    "FirstLinePracticeLocationAddress": "505 N FRANKLIN AVE",
    "SecondLinePracticeLocationAddress": "STE B",
    "PracticeLocationAddressCityName": "COLBY",
    "PracticeLocationAddressStateName": "KS",
    "PracticeLocationAddressPostalCode": "67701-2356",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "785-462-3348",
    "PracticeLocationAddressFaxNumber": "785-462-3599",
    "EnumerationDate": "09/28/2007",
    "LastUpdateDate": "11/04/2008",
    "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": "152W00000X",
        "TaxonomyName": "Optometrist",
        "LicenseNumber": "1111-3",
        "LicenseNumberStateCode": "KS",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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