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1306222799 NPI number — PRESTON BROWN PT, DPT

NPI Number: 1306222799
Health Care Provider/Practitioner: PRESTON BROWN PT, DPT

Information about “1306222799” NPI (PRESTON BROWN PT, DPT) exists in 1306222799 in HTML format HTML  |  1306222799 in plain Text format TXT  |  1306222799 in PDF (Portable Document Format) PDF  |  1306222799 in an XML format XML  formats.

NPI Number : 1306222799 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1306222799",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "BROWN",
    "FirstName": "PRESTON",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "PT, DPT",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "1200 CORPORATE DR STE 400",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "HOOVER",
    "MailingAddressStateName": "AL",
    "MailingAddressPostalCode": "35242-5424",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "423-777-6236",
    "MailingAddressFaxNumber": "423-954-7399",
    "FirstLinePracticeLocationAddress": "519 UNIVERSITY PL STE 119",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "DURANT",
    "PracticeLocationAddressStateName": "OK",
    "PracticeLocationAddressPostalCode": "74701-7102",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "580-634-7556",
    "PracticeLocationAddressFaxNumber": "580-319-7904",
    "EnumerationDate": "08/07/2015",
    "LastUpdateDate": "11/01/2022",
    "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": "225100000X",
          "TaxonomyName": "Physical Therapist",
          "LicenseNumber": "1262136",
          "LicenseNumberStateCode": "TX",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "225100000X",
          "TaxonomyName": "Physical Therapist",
          "LicenseNumber": "115430",
          "LicenseNumberStateCode": "OK",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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