{
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"FirstLineMailingAddress": "600 4TH ST SW",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MAGEE",
"MailingAddressStateName": "MS",
"MailingAddressPostalCode": "39111-3929",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "601-849-3636",
"MailingAddressFaxNumber": "601-849-2644",
"FirstLinePracticeLocationAddress": "600 4TH ST SW",
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"PracticeLocationAddressFaxNumber": "601-849-2644",
"EnumerationDate": "10/02/2008",
"LastUpdateDate": "10/02/2008",
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"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "OVERSTREET",
"AuthorizedOfficialFirstName": "ANGELA",
"AuthorizedOfficialMiddleName": "NEELY",
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"AuthorizedOfficialCredential": "DMD",
"AuthorizedOfficialTelephoneNumber": "601-849-3636",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Dentist",
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"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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"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."
}
}
}
}