{
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"FirstLineMailingAddress": "509 SUMTER ST",
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"MailingAddressCityName": "MONTEZUMA",
"MailingAddressStateName": "GA",
"MailingAddressPostalCode": "31063-1733",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "478-472-2321",
"MailingAddressFaxNumber": "478-472-2672",
"FirstLinePracticeLocationAddress": "502 SUMTER ST",
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"PracticeLocationAddressCityName": "MONTEZUMA",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "478-472-7429",
"PracticeLocationAddressFaxNumber": "478-472-5142",
"EnumerationDate": "11/11/2009",
"LastUpdateDate": "06/20/2018",
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"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SCHUPP",
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"AuthorizedOfficialCredential": "CEO",
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"Taxonomies": {
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"PrimaryTaxonomySwitch": "Y"
}
},
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}
}