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1467730952 NPI number — JACK C. MONTGOMERY VA MEDICAL CENTER

NPI Number: 1467730952
Health Care Provider/Practitioner: JACK C. MONTGOMERY VA MEDICAL CENTER

Information about “1467730952” NPI (JACK C. MONTGOMERY VA MEDICAL CENTER) exists in 1467730952 in HTML format HTML  |  1467730952 in plain Text format TXT  |  1467730952 in PDF (Portable Document Format) PDF  |  1467730952 in an XML format XML  formats.

NPI Number : 1467730952 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1467730952",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "JACK C. MONTGOMERY VA MEDICAL CENTER",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "102 YORK VILLAGE DR",
    "SecondLineMailingAddress": "APT 1",
    "MailingAddressCityName": "MUSKOGEE",
    "MailingAddressStateName": "OK",
    "MailingAddressPostalCode": "74403-4843",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "918-616-4626",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "102 YORK VILLAGE DR",
    "SecondLinePracticeLocationAddress": "APT 1",
    "PracticeLocationAddressCityName": "MUSKOGEE",
    "PracticeLocationAddressStateName": "OK",
    "PracticeLocationAddressPostalCode": "74403-4843",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "918-616-4626",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "08/01/2011",
    "LastUpdateDate": "08/01/2011",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "SORENSON",
    "AuthorizedOfficialFirstName": "GREGORY",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "CHIEF, VOLUNTARY SERVICES",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "918-577-3621",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "251V00000X",
        "TaxonomyName": "Voluntary or Charitable Agency",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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