{
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"FirstLineMailingAddress": "609 S 2ND ST",
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"MailingAddressStateName": "OK",
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"EnumerationDate": "07/04/2025",
"LastUpdateDate": "07/04/2025",
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"NPIReactivationDate": null,
"GenderCode": null,
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"AuthorizedOfficialLastName": "WARD",
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"Taxonomies": {
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"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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}
}
}
}