{
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"NamePrefix": null,
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"FirstLineMailingAddress": "PO BOX 56",
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"MailingAddressCityName": "SCOTTSBORO",
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"MailingAddressPostalCode": "35768-0056",
"MailingAddressCountryCode": "US",
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"MailingAddressFaxNumber": "256-259-0560",
"FirstLinePracticeLocationAddress": "506 HARLEY ST",
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"PracticeLocationAddressFaxNumber": "256-259-0560",
"EnumerationDate": "06/03/2011",
"LastUpdateDate": "06/03/2011",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ATA",
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"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "M.D.",
"AuthorizedOfficialTelephoneNumber": "256-451-1250",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": "AL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}