{
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"EIN": null,
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"IsOrgSubpart": "N",
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"OrgName": "DOROTHY M. MUNCH, D.O., LLC",
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"NamePrefix": null,
"NameSuffix": null,
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"FirstLineMailingAddress": "930 N WESTWOOD BLVD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "POPLAR BLUFF",
"MailingAddressStateName": "MO",
"MailingAddressPostalCode": "63901-4242",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "573-778-1620",
"MailingAddressFaxNumber": "573-778-1486",
"FirstLinePracticeLocationAddress": "930 N WESTWOOD BLVD",
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"PracticeLocationAddressCityName": "POPLAR BLUFF",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "573-778-1620",
"PracticeLocationAddressFaxNumber": "573-778-1486",
"EnumerationDate": "09/09/2008",
"LastUpdateDate": "09/09/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MCALISTER",
"AuthorizedOfficialFirstName": "PAULA",
"AuthorizedOfficialMiddleName": "J",
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"AuthorizedOfficialCredential": "BSHA/LTC",
"AuthorizedOfficialTelephoneNumber": "573-778-1697",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Family Medicine Physician",
"LicenseNumber": "36720",
"LicenseNumberStateCode": "MO",
"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."
}
}
}
}