Physician Compare National (NPI:1174750749)

HEALTHCARE PROVIDER: MATTHEW JOSEPH COMSTOCK 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	1174750749
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	5991992141
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20101214000499
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	COMSTOCK
	Individual professional last name
Provider First Name	MATTHEW
	Individual professional first name
Provider Middle Name	J
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OKLAHOMA STATE UNIVERSITY COLLEGE OF OSTEOPATHIC MEDICINE
	Individual professional's medical school
Graduation Year	2009
	Individual professional's medical school graduation year
Primary Specialty	INTERVENTIONAL CARDIOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	CARDIOVASCULAR DISEASE (CARDIOLOGY)
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	CARDIOVASCULAR DISEASE (CARDIOLOGY)
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	11912 S NORWOOD AVE
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 110
	Group Practice or individual's line 2 address
City	TULSA
	Group Practice or individual's city
State	OK
	Group Practice or individual's state
Zip Code	741375509
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	370078
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	OKLAHOMA STATE UNIVERSITY MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y