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1639357668 NPI number — JOHNNY L. KIRBY JR. LPA

NPI Number: 1639357668
Health Care Provider/Practitioner: JOHNNY L. KIRBY JR. LPA

Information about “1639357668” NPI (JOHNNY L. KIRBY JR. LPA) exists in 1639357668 in HTML format HTML  |  1639357668 in plain Text format TXT  |  1639357668 in PDF (Portable Document Format) PDF  |  1639357668 in an XML format XML  formats.

NPI Number : 1639357668 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1639357668",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "KIRBY",
    "FirstName": "JOHNNY",
    "MiddleName": "L.",
    "NamePrefix": "MR.",
    "NameSuffix": "JR.",
    "Credential": "LPA",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "75 BROWNING DR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "TAYLORSVILLE",
    "MailingAddressStateName": "NC",
    "MailingAddressPostalCode": "28681-6642",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "828-315-1368",
    "MailingAddressFaxNumber": "828-270-7868",
    "FirstLinePracticeLocationAddress": "211 S NC 127 HWY",
    "SecondLinePracticeLocationAddress": "SUITE 130",
    "PracticeLocationAddressCityName": "HICKORY",
    "PracticeLocationAddressStateName": "NC",
    "PracticeLocationAddressPostalCode": "28602-3541",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "828-315-1368",
    "PracticeLocationAddressFaxNumber": "828-270-7868",
    "EnumerationDate": "01/31/2008",
    "LastUpdateDate": "09/20/2012",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "103T00000X",
          "TaxonomyName": "Psychologist",
          "LicenseNumber": "2364",
          "LicenseNumberStateCode": "NC",
          "PrimaryTaxonomySwitch": "Y"
        },
        {
          "TaxonomyCode": "103TS0200X",
          "TaxonomyName": "School Psychologist",
          "LicenseNumber": "2364",
          "LicenseNumberStateCode": "NC",
          "PrimaryTaxonomySwitch": "N"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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