{
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"FirstLineMailingAddress": "PO BOX 268852",
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"MailingAddressCityName": "OKLAHOMA CITY",
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"MailingAddressPostalCode": "73126-8852",
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"MailingAddressTelephoneNumber": "405-376-0376",
"MailingAddressFaxNumber": "405-376-1233",
"FirstLinePracticeLocationAddress": "501 N MUSTANG RD",
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"EnumerationDate": "05/15/2007",
"LastUpdateDate": "02/02/2009",
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BAIN",
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"AuthorizedOfficialTelephoneNumber": "405-231-3824",
"Taxonomies": {
"Taxonomy": {
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}
},
"HealthcareProviderTaxonomyGroups": {
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}
}
}
}