{
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"EIN": null,
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"IsOrgSubpart": "N",
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"OrgName": "GI ASSOCIATES, PC",
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"NamePrefix": null,
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"FirstLineMailingAddress": "2560 NW MEDICAL PARK DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ROSEBURG",
"MailingAddressStateName": "OR",
"MailingAddressPostalCode": "97471-5510",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "541-673-2044",
"MailingAddressFaxNumber": "541-673-0454",
"FirstLinePracticeLocationAddress": "2560 NW MEDICAL PARK DR",
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"PracticeLocationAddressCityName": "ROSEBURG",
"PracticeLocationAddressStateName": "OR",
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"PracticeLocationAddressCountryCode": "US",
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"PracticeLocationAddressFaxNumber": "541-673-0454",
"EnumerationDate": "05/19/2009",
"LastUpdateDate": "05/19/2009",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "HARPOLE",
"AuthorizedOfficialFirstName": "THOMAS",
"AuthorizedOfficialMiddleName": "J",
"AuthorizedOfficialTitle": "CORP PRESIDENT",
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"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "MD",
"AuthorizedOfficialTelephoneNumber": "541-673-2044",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "207RG0100X",
"TaxonomyName": "Gastroenterology Physician",
"LicenseNumber": "MD12260",
"LicenseNumberStateCode": "OR",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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"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."
}
}
}
}