{
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"OrgName": "LYDIA LANE DWORKIN, M.D. PA",
"LastName": null,
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"NamePrefix": null,
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"FirstLineMailingAddress": "402 W GRAND AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "HOT SPRINGS",
"MailingAddressStateName": "AR",
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"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "501-624-1204",
"MailingAddressFaxNumber": "501-624-6800",
"FirstLinePracticeLocationAddress": "402 W GRAND AVE",
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"PracticeLocationAddressCityName": "HOT SPRINGS",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "501-624-1204",
"PracticeLocationAddressFaxNumber": "501-624-6800",
"EnumerationDate": "05/11/2007",
"LastUpdateDate": "08/22/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "HRDLICKA",
"AuthorizedOfficialFirstName": "RENATA",
"AuthorizedOfficialMiddleName": "L.",
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"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "501-624-1204",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "174400000X",
"TaxonomyName": "Specialist",
"LicenseNumber": "E4078",
"LicenseNumberStateCode": "AR",
"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."
}
}
}
}