Physician Compare National (NPI:1235168626)

HEALTHCARE PROVIDER: EUGENE B FERRIS MD

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

Individual Professional Information
NPI	1235168626
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	5597838185
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20080715000445
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	FERRIS
	Individual professional last name
Provider First Name	EUGENE
	Individual professional first name
Provider Middle Name	B
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	1969
	Individual professional's medical school graduation year
Primary Specialty	GENERAL SURGERY
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	VASCULAR SURGERY
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	VASCULAR SURGERY
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Organization Legal Name	VICKSBURG CLINIC LLC
	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	5890696330
	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	25
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	54 SERGEANT PRENTISS DR
	Group Practice or individual's line 1 address
City	NATCHEZ
	Group Practice or individual's city
State	MS
	Group Practice or individual's state
Zip Code	391204726
	Group Practice or individual's zip code (9 digits when available)
Phone Number	6018835858
	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	250031
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	MERIT HEALTH RIVER REGION
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y