Physician Compare National (NPI:1164418737)

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	1164418737
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	1557555299
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20101027000380
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	EILERS
	Individual professional last name
Provider First Name	JOHN
	Individual professional first name
Provider Middle Name	WILLIAM
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	WEST VIRGINIA SCHOOL OF OSTEOPATHIC MEDICINE
	Individual professional's medical school
Graduation Year	1992
	Individual professional's medical school graduation year
Primary Specialty	FAMILY MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	OSTEOPATHIC MANIPULATIVE MEDICINE
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	OSTEOPATHIC MANIPULATIVE MEDICINE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	431 CASS RD
	Group Practice or individual's line 1 address
City	SLATYFORK
	Group Practice or individual's city
State	WV
	Group Practice or individual's state
Zip Code	262919014
	Group Practice or individual's zip code (9 digits when available)
Phone Number	3045724410
	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	511314
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	POCAHONTAS MEMORIAL HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	510030
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	DAVIS MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y