Physician Compare National (NPI:1265540777)

HEALTHCARE PROVIDER: DAVE K JAIN DO

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

Individual Professional Information
NPI	1265540777
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	3476631680
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20080428000636
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	JAIN
	Individual professional last name
Provider First Name	DAVE
	Individual professional first name
Provider Middle Name	K
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	AT STILL UNIVERSITY OF HEALTH SCIENCES, COLLEGE OF OSTEO MED, KIRKSVILLE
	Individual professional's medical school
Graduation Year	1987
	Individual professional's medical school graduation year
Primary Specialty	INTERNAL MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	CARDIOVASCULAR DISEASE (CARDIOLOGY)
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	CARDIOVASCULAR DISEASE (CARDIOLOGY)
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	201 FLOYD ST
	Group Practice or individual's line 1 address
City	KENNETT
	Group Practice or individual's city
State	MO
	Group Practice or individual's state
Zip Code	638572450
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	041330
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	PIGGOTT COMMUNITY HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	260070
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	PEMISCOT COUNTY MEMORIAL HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	040020
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	ST BERNARDS MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	040039
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	ARKANSAS METHODIST MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 4
Hospital Affiliation CCN 5	260119
	Medicare CCN of hospital where individual professional provides service 5
Hospital Affiliation LBN 5	POPLAR BLUFF REGIONAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 5
Professional Accepts Medicare Assignment	Y

Physician Compare National (NPI:1265540777)

HEALTHCARE PROVIDER: DAVE K JAIN DO

Individual Professional Information

Medical School Information

Practice Information

Hospital(s) Affiliation Information