Physician Compare National (NPI:1063659803)

HEALTHCARE PROVIDER: VAL ELBERT HADDON II 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	1063659803
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	0143498618
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20110728000121
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	HADDON
	Individual professional last name
Provider First Name	VAL
	Individual professional first name
Provider Middle Name	ELBERT
	Individual professional middle name
Provider Name Suffix Text	II
	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	BARRY UNIVERSITY SCHOOL OF PODIATRIC MEDICINE
	Individual professional's medical school
Graduation Year	2008
	Individual professional's medical school graduation year
Primary Specialty	PODIATRY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	ANKLE AND FOOT CENTER OF TAMPA BAY
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	9133187107
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	13
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	11373 CORTEZ BLVD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 305
	Group Practice or individual's line 2 address
City	BROOKSVILLE
	Group Practice or individual's city
State	FL
	Group Practice or individual's state
Zip Code	346135411
	Group Practice or individual's zip code (9 digits when available)
Phone Number	3525968348
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	100264
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	OAK HILL HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y