{
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"FirstLineMailingAddress": "9375 E VISTA DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "HILLSBORO",
"MailingAddressStateName": "MO",
"MailingAddressPostalCode": "63050-3218",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "636-797-2611",
"MailingAddressFaxNumber": "636-797-2611",
"FirstLinePracticeLocationAddress": "3933 S BROADWAY",
"SecondLinePracticeLocationAddress": "LIMB PRESERVATION CENTER",
"PracticeLocationAddressCityName": "SAINT LOUIS",
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"EnumerationDate": "07/30/2012",
"LastUpdateDate": "07/30/2012",
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"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BILLY",
"AuthorizedOfficialFirstName": "LAWRENCE",
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"AuthorizedOfficialCredential": "MD",
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"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Surgery Physician",
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"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."
}
}
}
}