Physician Compare National (NPI:1003871013)

HEALTHCARE PROVIDER: HENRY GREENE BRYANT III DPM

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1003871013
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	0941314918
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20101227000078
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	BRYANT
	Individual professional last name
Provider First Name	HENRY
	Individual professional first name
Provider Middle Name	G
	Individual professional middle name
Provider Name Suffix Text	III
	The name suffix of the provider if the provider is an individual. The name suffix is a ''generation-related'' suffix, such as Jr., Sr., II, III, IV, or V.
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1988
	Individual professional's medical school graduation year
Primary Specialty	PODIATRY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	4321 UNIVERSITY PKWY
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 103
	Group Practice or individual's line 2 address
City	EVANS
	Group Practice or individual's city
State	GA
	Group Practice or individual's state
Zip Code	308093093
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	110028
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	UNIVERSITY HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	M