{
"Npi": {
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "CECIL D BOWEN JR, MD A PROFRSSIONAL CORPORATION",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
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"OtherOrgNameTypeCode": null,
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"OtherCredential": null,
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"FirstLineMailingAddress": "PO BOX 1175",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BLYTHE",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "92226-1175",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "760-861-0432",
"MailingAddressFaxNumber": "760-921-8674",
"FirstLinePracticeLocationAddress": "250 N 1ST ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "BLYTHE",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "92225-1702",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "760-921-5202",
"PracticeLocationAddressFaxNumber": "760-921-8674",
"EnumerationDate": "04/11/2007",
"LastUpdateDate": "01/05/2010",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BOWEN",
"AuthorizedOfficialFirstName": "CECIL",
"AuthorizedOfficialMiddleName": "D",
"AuthorizedOfficialTitle": "MEDICAL DOCTOR",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": "JR.",
"AuthorizedOfficialCredential": "MD",
"AuthorizedOfficialTelephoneNumber": "760-861-0432",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "2085R0202X",
"TaxonomyName": "Diagnostic Radiology Physician",
"LicenseNumber": "G66633",
"LicenseNumberStateCode": "CA",
"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."
}
}
}
}