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1437374915 NPI number — GUY B WILSON JR. D.PH

NPI Number: 1437374915
Health Care Provider/Practitioner: GUY B WILSON JR. D.PH

Information about “1437374915” NPI (GUY B WILSON JR. D.PH) exists in 1437374915 in HTML format HTML  |  1437374915 in plain Text format TXT  |  1437374915 in PDF (Portable Document Format) PDF  |  1437374915 in an XML format XML  formats.

NPI Number : 1437374915 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1437374915",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "WILSON",
    "FirstName": "GUY",
    "MiddleName": "B",
    "NamePrefix": "DR.",
    "NameSuffix": "JR.",
    "Credential": "D.PH",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "PO BOX 3582",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "JOHNSON CITY",
    "MailingAddressStateName": "TN",
    "MailingAddressPostalCode": "37602-3582",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "423-926-6154",
    "MailingAddressFaxNumber": "423-926-5571",
    "FirstLinePracticeLocationAddress": "525 N STATE OF FRANKLIN RD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "JOHNSON CITY",
    "PracticeLocationAddressStateName": "TN",
    "PracticeLocationAddressPostalCode": "37604-8213",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "423-926-6154",
    "PracticeLocationAddressFaxNumber": "423-926-5571",
    "EnumerationDate": "04/17/2007",
    "LastUpdateDate": "07/08/2007",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "183500000X",
        "TaxonomyName": "Pharmacist",
        "LicenseNumber": "3189",
        "LicenseNumberStateCode": "TN",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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