{
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"OrgName": "FORD FAMILY EYE CARE, P.C.",
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"NamePrefix": null,
"NameSuffix": null,
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"FirstLineMailingAddress": "5154 THOUSAND OAKS CV NW",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "KENNESAW",
"MailingAddressStateName": "GA",
"MailingAddressPostalCode": "30152-2861",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "770-528-6607",
"MailingAddressFaxNumber": "770-459-8673",
"FirstLinePracticeLocationAddress": "600 CARROLLTON VILLA RICA HWY",
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"PracticeLocationAddressCityName": "VILLA RICA",
"PracticeLocationAddressStateName": "GA",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "770-459-8733",
"PracticeLocationAddressFaxNumber": "770-459-8673",
"EnumerationDate": "08/22/2006",
"LastUpdateDate": "08/22/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "FORD",
"AuthorizedOfficialFirstName": "EDWARD",
"AuthorizedOfficialMiddleName": "R",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "O.D.",
"AuthorizedOfficialTelephoneNumber": "770-528-6607",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "152W00000X",
"TaxonomyName": "Optometrist",
"LicenseNumber": "1874",
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"PrimaryTaxonomySwitch": "N"
},
{
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}
]
},
"HealthcareProviderTaxonomyGroups": {
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{
"HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
},
{
"HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
]
}
}
}