{
"Npi": {
"NPI": "1710959606",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "JEFFERS",
"FirstName": "WILL",
"MiddleName": "VAHID",
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "D.O.",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "9340 W PONTIAC DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "PEORIA",
"MailingAddressStateName": "AZ",
"MailingAddressPostalCode": "85382-5180",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "623-825-6437",
"MailingAddressFaxNumber": "623-475-5582",
"FirstLinePracticeLocationAddress": "8631 W UNION HILLS DR",
"SecondLinePracticeLocationAddress": "206",
"PracticeLocationAddressCityName": "PEORIA",
"PracticeLocationAddressStateName": "AZ",
"PracticeLocationAddressPostalCode": "85382-7002",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "623-875-7900",
"PracticeLocationAddressFaxNumber": "623-875-7919",
"EnumerationDate": "02/03/2006",
"LastUpdateDate": "07/09/2007",
"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": "207Q00000X",
"TaxonomyName": "Family Medicine Physician",
"LicenseNumber": "3307",
"LicenseNumberStateCode": "AZ",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}