{
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
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"OrgName": "IRVIN JOHN SNYDER",
"LastName": null,
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"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
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"FirstLineMailingAddress": "174 PINNELL ST",
"SecondLineMailingAddress": "SUITE A",
"MailingAddressCityName": "RIPLEY",
"MailingAddressStateName": "WV",
"MailingAddressPostalCode": "25271-9103",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "304-372-7617",
"MailingAddressFaxNumber": "304-372-7619",
"FirstLinePracticeLocationAddress": "174 PINNELL ST",
"SecondLinePracticeLocationAddress": "SUITE A",
"PracticeLocationAddressCityName": "RIPLEY",
"PracticeLocationAddressStateName": "WV",
"PracticeLocationAddressPostalCode": "25271-9103",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "304-372-7617",
"PracticeLocationAddressFaxNumber": "304-372-7619",
"EnumerationDate": "04/26/2007",
"LastUpdateDate": "10/18/2016",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SNYDER",
"AuthorizedOfficialFirstName": "IRVIN",
"AuthorizedOfficialMiddleName": "JOHN",
"AuthorizedOfficialTitle": "PHYSICIAN",
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"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DO",
"AuthorizedOfficialTelephoneNumber": "304-372-7617",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "207R00000X",
"TaxonomyName": "Internal Medicine Physician",
"LicenseNumber": "1413",
"LicenseNumberStateCode": "WV",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X 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."
}
}
}
}