Physician Compare National (NPI:1053535963)

HEALTHCARE PROVIDER: MICHAEL O STULTZ D.C.

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

Individual Professional Information
NPI	1053535963
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	1658304746
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20080731000417
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	STULTZ
	Individual professional last name
Provider First Name	MICHAEL
	Individual professional first name
Provider Middle Name	O
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	CLEVELAND CHIROPRACTIC COLLEGE - LOS ANGELES
	Individual professional's medical school
Graduation Year	1995
	Individual professional's medical school graduation year
Primary Specialty	CHIROPRACTIC
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	PHYSICAL MEDICINE AND REHABILITATION
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	PHYSICAL MEDICINE AND REHABILITATION
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	1024 WILLOW CREEK RD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE C
	Group Practice or individual's line 2 address
City	PRESCOTT
	Group Practice or individual's city
State	AZ
	Group Practice or individual's state
Zip Code	863011610
	Group Practice or individual's zip code (9 digits when available)
Phone Number	9287786200
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y