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1306393830 NPI number — THAXTON MEDICAL CLINIC, LLC

NPI Number: 1306393830
Health Care Provider/Practitioner: THAXTON MEDICAL CLINIC, LLC

Information about “1306393830” NPI (THAXTON MEDICAL CLINIC, LLC) exists in 1306393830 in HTML format HTML  |  1306393830 in plain Text format TXT  |  1306393830 in PDF (Portable Document Format) PDF  |  1306393830 in an XML format XML  formats.

NPI Number : 1306393830 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1306393830",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "THAXTON MEDICAL CLINIC, LLC",
    "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": "PO BOX 99",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "THAXTON",
    "MailingAddressStateName": "MS",
    "MailingAddressPostalCode": "38871-0099",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "662-489-8500",
    "MailingAddressFaxNumber": "662-489-8600",
    "FirstLinePracticeLocationAddress": "11145 HIGHWAY 6 WEST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "THAXTON",
    "PracticeLocationAddressStateName": "MS",
    "PracticeLocationAddressPostalCode": "38871",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "662-489-8500",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "09/01/2016",
    "LastUpdateDate": "11/16/2016",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "HOOKER",
    "AuthorizedOfficialFirstName": "ELIZABETH",
    "AuthorizedOfficialMiddleName": "BROOKE",
    "AuthorizedOfficialTitle": "OWNER/",
    "AuthorizedOfficialNamePrefix": "MRS.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "RT",
    "AuthorizedOfficialTelephoneNumber": "662-489-8500",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "363L00000X",
          "TaxonomyName": "Nurse Practitioner",
          "LicenseNumber": "R850403",
          "LicenseNumberStateCode": "MS",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363L00000X",
          "TaxonomyName": "Nurse Practitioner",
          "LicenseNumber": "901698",
          "LicenseNumberStateCode": "MS",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "261QP2300X",
          "TaxonomyName": "Primary Care Clinic/Center",
          "LicenseNumber": "23667",
          "LicenseNumberStateCode": "MS",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": [
        {
          "HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
        }
      ]
    }
  }
}
                
            

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