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1821116369 NPI number — JOHN DOUGLAS LEITCH JR. DDS

NPI Number: 1821116369
Health Care Provider/Practitioner: JOHN DOUGLAS LEITCH JR. DDS

Information about “1821116369” NPI (JOHN DOUGLAS LEITCH JR. DDS) exists in 1821116369 in HTML format HTML  |  1821116369 in plain Text format TXT  |  1821116369 in PDF (Portable Document Format) PDF  |  1821116369 in an XML format XML  formats.

NPI Number : 1821116369 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1821116369",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "LEITCH",
    "FirstName": "JOHN",
    "MiddleName": "DOUGLAS",
    "NamePrefix": "DR.",
    "NameSuffix": "JR.",
    "Credential": "DDS",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "PO BOX 380",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "HUNT",
    "MailingAddressStateName": "TX",
    "MailingAddressPostalCode": "78024-0380",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "830-238-7654",
    "MailingAddressFaxNumber": "830-238-7684",
    "FirstLinePracticeLocationAddress": "380 FALLOW RUN",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "HUNT",
    "PracticeLocationAddressStateName": "TX",
    "PracticeLocationAddressPostalCode": "78024-0380",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "830-238-7654",
    "PracticeLocationAddressFaxNumber": "830-238-7684",
    "EnumerationDate": "03/26/2007",
    "LastUpdateDate": "07/08/2007",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "1223E0200X",
        "TaxonomyName": "Endodontics",
        "LicenseNumber": "14087",
        "LicenseNumberStateCode": "TX",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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