Physician Compare National (NPI:1194081422)

HEALTHCARE PROVIDER: ALEXCIS THOMSON FORD 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	1194081422
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	9234383167
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20190917001434
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	FORD
	Individual professional last name
Provider First Name	ALEXCIS
	Individual professional first name
Provider Middle Name	THOMSON
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF SOUTHERN CALIFORNIA KECK SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	2012
	Individual professional's medical school graduation year
Primary Specialty	OBSTETRICS/GYNECOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	ADVANCED GYNECOLOGY PC
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	0143568634
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	6
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	11660 ALPHARETTA HWY
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 710
	Group Practice or individual's line 2 address
City	ROSWELL
	Group Practice or individual's city
State	GA
	Group Practice or individual's state
Zip Code	300764916
	Group Practice or individual's zip code (9 digits when available)
Phone Number	6783448900
	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	110161
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	NORTHSIDE HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y