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Physician Compare National (NPI:1104912476)

HEALTHCARE PROVIDER: JOHN E BALMER JR. D.O.

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

Individual Professional Information

NPI 1104912476
Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID 9032020953
Unique individual clinician ID assigned by PECOS
Professional Enrollment ID I20041206000579
Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name BALMER
Individual professional last name
Provider First Name JOHN
Individual professional first name
Provider Middle Name E
Individual professional middle name
Provider Name Suffix Text JR.
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.
Provider Credential Text DO
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 UNIVERSITY OF NEW ENGLAND, COLLEGE OF OSTEO MEDICINE
Individual professional's medical school
Graduation Year 1990
Individual professional's medical school graduation year
Primary Specialty EMERGENCY MEDICINE
Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1 FAMILY MEDICINE
First secondary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 2 NEUROLOGY
Second secondary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 3 PAIN MANAGEMENT
Third secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties FAMILY MEDICINE, NEUROLOGY, PAIN MANAGEMENT
All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information

Line 1 Street Address 116 MECHANIC ST
Group Practice or individual's line 1 address
City SPARTANSBURG
Group Practice or individual's city
State PA
Group Practice or individual's state
Zip Code 164341026
Group Practice or individual's zip code (9 digits when available)
Phone Number 8146547334
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 391308
Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1 LECOM HEALTH CORRY MEMORIAL HOSPITAL
Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2 390104
Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2 KANE COMMUNITY HOSPITAL
Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3 391314
Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3 TITUSVILLE HOSPITAL
Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4 390113
Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4 MEADVILLE MEDICAL CENTER
Legal business name of hospital where individual professional provides service 4
Hospital Affiliation CCN 5 390009
Medicare CCN of hospital where individual professional provides service 5
Hospital Affiliation LBN 5 SAINT VINCENT HOSPITAL
Legal business name of hospital where individual professional provides service 5
Professional Accepts Medicare Assignment Y

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