{
"Npi": {
"NPI": "1275812091",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "O L PUTTLER JR MD A PROFESSIONAL CORPORATION",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "3798 JANES RD",
"SecondLineMailingAddress": "SUITE 15",
"MailingAddressCityName": "ARCATA",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "95521-4753",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "707-822-1131",
"MailingAddressFaxNumber": "707-822-0746",
"FirstLinePracticeLocationAddress": "3798 JANES RD",
"SecondLinePracticeLocationAddress": "SUITE 15",
"PracticeLocationAddressCityName": "ARCATA",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "95521-4753",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "707-822-1131",
"PracticeLocationAddressFaxNumber": "707-822-0746",
"EnumerationDate": "08/10/2011",
"LastUpdateDate": "09/12/2017",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "PUTTLER",
"AuthorizedOfficialFirstName": "OLIVER",
"AuthorizedOfficialMiddleName": "L",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": "JR.",
"AuthorizedOfficialCredential": "MD",
"AuthorizedOfficialTelephoneNumber": "707-822-1131",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QM1300X",
"TaxonomyName": "Multi-Specialty Clinic/Center",
"LicenseNumber": "G13904",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}