Physician Compare National (NPI:1245435387)

HEALTHCARE PROVIDER: DAVID RANDOLPH GORE O.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	1245435387
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	2264562578
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20100614000670
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	GORE
	Individual professional last name
Provider First Name	DAVID
	Individual professional first name
Provider Middle Name	RANDOLPH
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	PENNSYLVANIA COLLEGE OF OPTOMETRY
	Individual professional's medical school
Graduation Year	1998
	Individual professional's medical school graduation year
Primary Specialty	OPTOMETRY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	6727 LEA BERRY WAY
	Group Practice or individual's line 1 address
City	HAYMARKET
	Group Practice or individual's city
State	VA
	Group Practice or individual's state
Zip Code	201692991
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	M