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"FirstLineMailingAddress": "PO BOX 990",
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"MailingAddressCountryCode": "US",
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"MailingAddressFaxNumber": "859-239-6785",
"FirstLinePracticeLocationAddress": "280 LINCOLN DR",
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"EnumerationDate": "05/30/2018",
"LastUpdateDate": "03/10/2025",
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"NPIReactivationDate": null,
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"Gender": null,
"AuthorizedOfficialLastName": "MCKAY",
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"AuthorizedOfficialTelephoneNumber": "859-239-2410",
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{
"TaxonomyCode": "261QR1300X",
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},
{
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}
]
},
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"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}