{
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"FirstLineMailingAddress": "4722 W KELLOGG DR",
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"MailingAddressCityName": "WICHITA",
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"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "316-440-2565",
"MailingAddressFaxNumber": "316-440-2750",
"FirstLinePracticeLocationAddress": "4722 W KELLOGG DR",
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"PracticeLocationAddressFaxNumber": "316-440-2750",
"EnumerationDate": "06/03/2014",
"LastUpdateDate": "07/21/2025",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "HERSHBERGER",
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"AuthorizedOfficialCredential": "MD",
"AuthorizedOfficialTelephoneNumber": "316-687-3275",
"Taxonomies": {
"Taxonomy": [
{
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"PrimaryTaxonomySwitch": "N"
},
{
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}
]
},
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}
}