{
"Npi": {
"NPI": "1700093705",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "ROBERT S. EAGERTON, JR. M.D.,LLC",
"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": "200 E HOSPITAL ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MANNING",
"MailingAddressStateName": "SC",
"MailingAddressPostalCode": "29102-3160",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "803-433-0439",
"MailingAddressFaxNumber": "803-433-9840",
"FirstLinePracticeLocationAddress": "200 E HOSPITAL ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "MANNING",
"PracticeLocationAddressStateName": "SC",
"PracticeLocationAddressPostalCode": "29102-3160",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "803-433-0439",
"PracticeLocationAddressFaxNumber": "803-433-9840",
"EnumerationDate": "05/17/2007",
"LastUpdateDate": "03/31/2009",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "EAGERTON",
"AuthorizedOfficialFirstName": "ROBERT",
"AuthorizedOfficialMiddleName": "S",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": "JR.",
"AuthorizedOfficialCredential": "M.D.",
"AuthorizedOfficialTelephoneNumber": "803-433-0439",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QR1300X",
"TaxonomyName": "Rural Health Clinic/Center",
"LicenseNumber": "11415",
"LicenseNumberStateCode": "SC",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}