{
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"EIN": null,
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"OrgName": "MINNESOTA ALLERGY AND ASTHMA CONSULTANTS, PLLC",
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"FirstLineMailingAddress": "675 E NICOLLET BLVD",
"SecondLineMailingAddress": "SUITE #250",
"MailingAddressCityName": "BURNSVILLE",
"MailingAddressStateName": "MN",
"MailingAddressPostalCode": "55337-6741",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "952-223-3404",
"MailingAddressFaxNumber": "952-223-3041",
"FirstLinePracticeLocationAddress": "675 E NICOLLET BLVD",
"SecondLinePracticeLocationAddress": "SUITE #250",
"PracticeLocationAddressCityName": "BURNSVILLE",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "952-223-3404",
"PracticeLocationAddressFaxNumber": "952-223-3041",
"EnumerationDate": "01/25/2007",
"LastUpdateDate": "04/10/2009",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "LAKIN",
"AuthorizedOfficialFirstName": "JAMES",
"AuthorizedOfficialMiddleName": "D",
"AuthorizedOfficialTitle": "MANAGING PARTNER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "PH.D., M.D.",
"AuthorizedOfficialTelephoneNumber": "952-223-3404",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Allergy & Immunology Physician",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
}
}
}
}