{
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"EIN": null,
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"IsOrgSubpart": "N",
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"OrgName": "GULF STATES REHABILITATION ASSOCIATES,LTD.",
"LastName": null,
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"NamePrefix": null,
"NameSuffix": null,
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"FirstLineMailingAddress": "4224 HOUMA BLVD",
"SecondLineMailingAddress": "SUITE 470",
"MailingAddressCityName": "METAIRIE",
"MailingAddressStateName": "LA",
"MailingAddressPostalCode": "70006-2933",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "504-456-5160",
"MailingAddressFaxNumber": "504-456-5021",
"FirstLinePracticeLocationAddress": "4224 HOUMA BLVD",
"SecondLinePracticeLocationAddress": "SUITE 470",
"PracticeLocationAddressCityName": "METAIRIE",
"PracticeLocationAddressStateName": "LA",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "504-456-5160",
"PracticeLocationAddressFaxNumber": "504-456-5021",
"EnumerationDate": "08/30/2007",
"LastUpdateDate": "08/30/2007",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "KNIGHT",
"AuthorizedOfficialFirstName": "WILLIAM",
"AuthorizedOfficialMiddleName": "R",
"AuthorizedOfficialTitle": "PHYSICIAN/OWNER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": "JR.",
"AuthorizedOfficialCredential": "DO",
"AuthorizedOfficialTelephoneNumber": "504-456-5160",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "208100000X",
"TaxonomyName": "Physical Medicine & Rehabilitation Physician",
"LicenseNumber": "08180R",
"LicenseNumberStateCode": "LA",
"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."
}
}
}
}