{
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"FirstLineMailingAddress": "1680 SCHROCK RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "COLUMBUS",
"MailingAddressStateName": "OH",
"MailingAddressPostalCode": "43229-1574",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "614-882-2223",
"MailingAddressFaxNumber": "614-891-8415",
"FirstLinePracticeLocationAddress": "1680 SCHROCK RD",
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"PracticeLocationAddressCityName": "COLUMBUS",
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"PracticeLocationAddressTelephoneNumber": "614-882-2223",
"PracticeLocationAddressFaxNumber": "614-891-8415",
"EnumerationDate": "09/07/2006",
"LastUpdateDate": "12/07/2007",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "GILLILAND",
"AuthorizedOfficialFirstName": "MICHAEL",
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"AuthorizedOfficialCredential": "O.D.",
"AuthorizedOfficialTelephoneNumber": "614-882-2223",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Optometrist",
"LicenseNumber": "3605",
"LicenseNumberStateCode": "OH",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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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."
}
}
}
}