Physician Compare National (NPI:1154412856)

HEALTHCARE PROVIDER: DAVE M. RAYBURN 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	1154412856
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	0547421091
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20120411000137
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	RAYBURN
	Individual professional last name
Provider First Name	DAVID
	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
Primary Specialty	GENERAL SURGERY
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	VASCULAR SURGERY
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	VASCULAR SURGERY
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	390 GRIFFITH ST
	Group Practice or individual's line 1 address
City	PINEVILLE
	Group Practice or individual's city
State	LA
	Group Practice or individual's state
Zip Code	713605271
	Group Practice or individual's zip code (9 digits when available)
Phone Number	3184436323
	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	190026
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	RAPIDES REGIONAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y