{
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"FirstLineMailingAddress": "P O BOX 14149",
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"MailingAddressCityName": "BATON ROUGE",
"MailingAddressStateName": "LA",
"MailingAddressPostalCode": "70898",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "601-442-6500",
"MailingAddressFaxNumber": "601-442-1509",
"FirstLinePracticeLocationAddress": "46 SEARGENT PRENTISS DRIVE",
"SecondLinePracticeLocationAddress": "SUITE 202",
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"EnumerationDate": "07/23/2007",
"LastUpdateDate": "07/23/2007",
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MELTON",
"AuthorizedOfficialFirstName": "MISTY",
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"AuthorizedOfficialTelephoneNumber": "601-446-6068",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "General Practice Physician",
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"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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}
}
}
}