Physician Compare National (NPI:1073518288)

HEALTHCARE PROVIDER: RONALD JC FEJERAN DO

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

Individual Professional Information
NPI	1073518288
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	2466345871
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20081107000512
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	FEJERAN
	Individual professional last name
Provider First Name	RONALD
	Individual professional first name
Provider Middle Name	J
	Individual professional middle name
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	1992
	Individual professional's medical school graduation year
Primary Specialty	INTERNAL MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	EMERGENCY MEDICINE
	First secondary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 2	FAMILY MEDICINE
	Second secondary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 3	OSTEOPATHIC MANIPULATIVE MEDICINE
	Third secondary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 4	PEDIATRIC MEDICINE
	Fourth secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	EMERGENCY MEDICINE, FAMILY MEDICINE, OSTEOPATHIC MANIPULATIVE MEDICINE, PEDIATRIC MEDICINE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	1442 N BROAD ST
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 7
	Group Practice or individual's line 2 address
City	TAZEWELL
	Group Practice or individual's city
State	TN
	Group Practice or individual's state
Zip Code	378794362
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	440057
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	CLAIBORNE MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y