Physician Compare National (NPI:1073547766)

HEALTHCARE PROVIDER: GARY MYRTHIL M.D.

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

Individual Professional Information
NPI	1073547766
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	3971412560
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20081124000522
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	MYRTHIL
	Individual professional last name
Provider First Name	GARY
	Individual professional first 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	1985
	Individual professional's medical school graduation year
Primary Specialty	NEPHROLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	INTERNAL MEDICINE
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	INTERNAL MEDICINE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	107 OSIGIAN BLVD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 100
	Group Practice or individual's line 2 address
City	WARNER ROBINS
	Group Practice or individual's city
State	GA
	Group Practice or individual's state
Zip Code	310887891
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	110069
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	HOUSTON MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	110153
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	PERRY HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	111310
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	MEDICAL CENTER OF PEACH COUNTY, NAVICENT HEALTH
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	110135
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	TAYLOR REGIONAL HOSPITAL
	Legal business name of hospital where individual professional provides service 4
Hospital Affiliation CCN 5	110092
	Medicare CCN of hospital where individual professional provides service 5
Hospital Affiliation LBN 5	DODGE COUNTY HOSPITAL
	Legal business name of hospital where individual professional provides service 5
Professional Accepts Medicare Assignment	Y

Physician Compare National (NPI:1073547766)

HEALTHCARE PROVIDER: GARY MYRTHIL M.D.

Individual Professional Information

Medical School Information

Practice Information

Hospital(s) Affiliation Information