Physician Compare National (NPI:1194728048)

HEALTHCARE PROVIDER: NORMAN I KORNBLATT D.P.M

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

Individual Professional Information
NPI	1194728048
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	9739376500
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20101206000591
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	KORNBLATT
	Individual professional last name
Provider First Name	NORMAN
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	KENT STATE UNIVERSITY COLLEGE OF PODIATRIC MEDICINE
	Individual professional's medical school
Graduation Year	1985
	Individual professional's medical school graduation year
Primary Specialty	PODIATRY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	3666 HWY 5
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 101
	Group Practice or individual's line 2 address
City	DOUGLASVILLE
	Group Practice or individual's city
State	GA
	Group Practice or individual's state
Zip Code	301352364
	Group Practice or individual's zip code (9 digits when available)
Phone Number	7709423668
	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	110184
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	WELLSTAR DOUGLAS HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y