Physician Compare National (NPI:1023002466)

HEALTHCARE PROVIDER: ERIC PETER CLARKE MD

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

Individual Professional Information
NPI	1023002466
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4183645823
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20051222000239
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	CLARKE
	Individual professional last name
Provider First Name	ERIC
	Individual professional first name
Provider Middle Name	P
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.
Provider Credential Text	MD
	The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information
Medical School Name	EAST TENNESSEE STATE UNIVERSITY QUILLEN COLLEGE OF MEDICINE
	Individual professional's medical school
Graduation Year	1988
	Individual professional's medical school graduation year
Primary Specialty	ORTHOPEDIC SURGERY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	2707 CITICO AVE
	Group Practice or individual's line 1 address
City	CHATTANOOGA
	Group Practice or individual's city
State	TN
	Group Practice or individual's state
Zip Code	374063402
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	440091
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	MEMORIAL HEALTHCARE SYSTEM, INC
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	440068
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	STARR REGIONAL MEDICAL CENTER ATHENS
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	440156
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	PARKRIDGE MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	Y