{
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"FirstLineMailingAddress": "PO BOX 7838",
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"MailingAddressCityName": "TEXARKANA",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "75505-7838",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "501-372-7246",
"MailingAddressFaxNumber": "501-324-1518",
"FirstLinePracticeLocationAddress": "500 S UNIVERSITY AVE STE 305",
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"PracticeLocationAddressCityName": "LITTLE ROCK",
"PracticeLocationAddressStateName": "AR",
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"PracticeLocationAddressFaxNumber": "501-324-1518",
"EnumerationDate": "05/08/2009",
"LastUpdateDate": "05/08/2009",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "REICHARD",
"AuthorizedOfficialFirstName": "ROBERT",
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"AuthorizedOfficialTitle": "OWNER",
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"AuthorizedOfficialNameSuffix": "JR.",
"AuthorizedOfficialCredential": "MD",
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"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Pain Medicine Physician",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"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."
}
}
}
}