Physician Compare National (NPI:1114008083)

HEALTHCARE PROVIDER:

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

Individual Professional Information
NPI	1114008083
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	2668546516
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20080811000472
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	CREECH
	Individual professional last name
Provider First Name	ROBERT
	Individual professional first name
Provider Middle Name	H
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF PITTSBURGH SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	1970
	Individual professional's medical school graduation year
Primary Specialty	ENDOCRINOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	1503 WINCHESTER RD
	Group Practice or individual's line 1 address
City	HUNTSVILLE
	Group Practice or individual's city
State	AL
	Group Practice or individual's state
Zip Code	358119186
	Group Practice or individual's zip code (9 digits when available)
Phone Number	2568529221
	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	010039
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	HUNTSVILLE HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y