{
"Npi": {
"NPI": "1346433521",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "ALEXANDER",
"FirstName": "ANDREA",
"MiddleName": "GARCIA",
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "MD",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "WADDELL",
"OtherFirstName": "ANDREA",
"OtherMiddleName": "GARCIA",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "MD",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "804 N WILEY AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "DONALSONVILLE",
"MailingAddressStateName": "GA",
"MailingAddressPostalCode": "39845-1120",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "229-524-2808",
"MailingAddressFaxNumber": "229-524-1272",
"FirstLinePracticeLocationAddress": "804 N WILEY AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "DONALSONVILLE",
"PracticeLocationAddressStateName": "GA",
"PracticeLocationAddressPostalCode": "39845-1120",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "229-524-2808",
"PracticeLocationAddressFaxNumber": "229-524-1272",
"EnumerationDate": "08/22/2007",
"LastUpdateDate": "03/07/2023",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
"Gender": "Female",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "207N00000X",
"TaxonomyName": "Dermatology Physician",
"LicenseNumber": "060626",
"LicenseNumberStateCode": "GA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}