{
"Npi": {
"NPI": "1851363253",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "Y",
"ParentOrgLBN": "AMERIPATH INC.",
"ParentOrgTIN": null,
"OrgName": "DIAGNOSTIC PATHOLOGY SERVICES, INC.",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "14275 MIDWAY RD",
"SecondLineMailingAddress": "SUITE 400",
"MailingAddressCityName": "ADDISON",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "75001-3614",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": null,
"MailingAddressFaxNumber": "610-271-4245",
"FirstLinePracticeLocationAddress": "225 NE 97TH ST",
"SecondLinePracticeLocationAddress": "SUITE 600",
"PracticeLocationAddressCityName": "OKLAHOMA CITY",
"PracticeLocationAddressStateName": "OK",
"PracticeLocationAddressPostalCode": "73114-6302",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "405-842-2061",
"PracticeLocationAddressFaxNumber": "405-842-3146",
"EnumerationDate": "02/02/2006",
"LastUpdateDate": "09/19/2024",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "WHEELER",
"AuthorizedOfficialFirstName": "DARREN",
"AuthorizedOfficialMiddleName": "THOMAS",
"AuthorizedOfficialTitle": "VICE PRESIDENT",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "702-733-7866",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "291U00000X",
"TaxonomyName": "Clinical Medical Laboratory",
"LicenseNumber": "37D0980824",
"LicenseNumberStateCode": "OK",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}