{
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"FirstLineMailingAddress": "PO BOX 16235",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "HATTIESBURG",
"MailingAddressStateName": "MS",
"MailingAddressPostalCode": "39404-6235",
"MailingAddressCountryCode": "US",
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"MailingAddressFaxNumber": "601-264-3150",
"FirstLinePracticeLocationAddress": "206 BAY AVE STE A",
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"PracticeLocationAddressCityName": "RICHTON",
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"EnumerationDate": "07/18/2017",
"LastUpdateDate": "08/01/2017",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ZALESKI",
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"AuthorizedOfficialCredential": "DPM",
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"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "213E00000X",
"TaxonomyName": "Podiatrist",
"LicenseNumber": "80131",
"LicenseNumberStateCode": "MS",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X 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."
}
}
}
}