{
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"FirstLineMailingAddress": "2100 BROOKWOOD DR",
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"MailingAddressStateName": "AR",
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"FirstLinePracticeLocationAddress": "516 NAKOMA DR",
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"PracticeLocationAddressCountryCode": "US",
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"PracticeLocationAddressFaxNumber": "601-366-2532",
"EnumerationDate": "10/24/2006",
"LastUpdateDate": "09/11/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "STROM",
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"AuthorizedOfficialTelephoneNumber": "501-296-3312",
"Taxonomies": {
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{
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"TaxonomyName": "Pharmacy",
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"PrimaryTaxonomySwitch": "N"
},
{
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}
]
},
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}
}