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Physician Compare National (NPI:1225015498)

HEALTHCARE PROVIDER: JAMES C GRAHAM DPM

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

Individual Professional Information

NPI 1225015498
Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID 1456466069
Unique individual clinician ID assigned by PECOS
Professional Enrollment ID I20110105001117
Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name GRAHAM
Individual professional last name
Provider First Name JAMES
Individual professional first name
Provider Middle Name CULLEN
Individual professional middle name
Provider Gender M
The provider's gender if the provider is a person.

Medical School Information

Medical School Name WILLIAM M. SCHOLL COLLEGE OF PODIATRIC MEDICINE
Individual professional's medical school
Graduation Year 1988
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 900 W TEMPLE
Group Practice or individual's line 1 address
Line 2 Street Address SUITE 202
Group Practice or individual's line 2 address
City EFFINGHAM
Group Practice or individual's city
State IL
Group Practice or individual's state
Zip Code 624012187
Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information

Hospital Affiliation CCN 1 140032
Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1 ST ANTHONYS MEMORIAL HOSPITAL
Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment Y

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