{
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"EIN": null,
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"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "PHARMACIST",
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"FirstLineMailingAddress": "2766 US HIGHWAY 421",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MIDWAY",
"MailingAddressStateName": "KY",
"MailingAddressPostalCode": "40347-9774",
"MailingAddressCountryCode": "US",
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"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1300 US HIGHWAY 127 S",
"SecondLinePracticeLocationAddress": "STE E",
"PracticeLocationAddressCityName": "FRANKFORT",
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"PracticeLocationAddressPostalCode": "40601-4395",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "502-223-3728",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "03/09/2012",
"LastUpdateDate": "03/09/2012",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "M",
"Gender": "Male",
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"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Pharmacist",
"LicenseNumber": "015588",
"LicenseNumberStateCode": "KY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}