{
"Npi": {
"NPI": "1609053784",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "WILLIAM M DAVIDSON PC",
"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": "PO BOX 1458",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ANDALUSIA",
"MailingAddressStateName": "AL",
"MailingAddressPostalCode": "36420-1225",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "334-222-8561",
"MailingAddressFaxNumber": "334-222-5032",
"FirstLinePracticeLocationAddress": "500 WESTGATE PLZ",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "ANDALUSIA",
"PracticeLocationAddressStateName": "AL",
"PracticeLocationAddressPostalCode": "36420-2525",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "334-222-8561",
"PracticeLocationAddressFaxNumber": "334-222-5032",
"EnumerationDate": "01/30/2008",
"LastUpdateDate": "03/05/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "DAVIDSON",
"AuthorizedOfficialFirstName": "WILLIAM",
"AuthorizedOfficialMiddleName": "M",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "OD",
"AuthorizedOfficialTelephoneNumber": "334-222-8561",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "332H00000X",
"TaxonomyName": "Eyewear Supplier",
"LicenseNumber": "S-355-TA-027",
"LicenseNumberStateCode": "AL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}