Physician Compare National (NPI:1285620104)

HEALTHCARE PROVIDER: DUSTIN GRUBBS OD

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

Individual Professional Information
NPI	1285620104
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	5597788521
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20060105000361
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	GRUBBS
	Individual professional last name
Provider First Name	DUSTIN
	Individual professional first name
Provider Middle Name	O
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.
Provider Credential Text	OD
	The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information
Medical School Name	UNIVERSITY ALABAMA BIRMINGHAM - SCHOOL OF OPTOMETRY
	Individual professional's medical school
Graduation Year	2000
	Individual professional's medical school graduation year
Primary Specialty	OPTOMETRY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	EMERALD COAST EYE CARE
	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	5193877322
	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	2
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	1714 W 23RD ST
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE K
	Group Practice or individual's line 2 address
City	PANAMA CITY
	Group Practice or individual's city
State	FL
	Group Practice or individual's state
Zip Code	324052924
	Group Practice or individual's zip code (9 digits when available)
Phone Number	8502159101
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y