Physician Compare National (NPI:1285852467)

HEALTHCARE PROVIDER: JAMES LOUIS FUQUA III M.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	1285852467
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	2961578661
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20170126000104
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	FUQUA
	Individual professional last name
Provider First Name	JAMES
	Individual professional first name
Provider Middle Name	L
	Individual professional middle name
Provider Name Suffix Text	III
	The name suffix of the provider if the provider is an individual. The name suffix is a ''generation-related'' suffix, such as Jr., Sr., II, III, IV, or V.
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF TENNESSEE, HSC, COLLEGE OF MEDICINE
	Individual professional's medical school
Graduation Year	2002
	Individual professional's medical school graduation year
Primary Specialty	DIAGNOSTIC RADIOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	MSK MONMOUTH
	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	1153619291
	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	124
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	480 RED HILL RD
	Group Practice or individual's line 1 address
City	MIDDLETOWN
	Group Practice or individual's city
State	NJ
	Group Practice or individual's state
Zip Code	077483052
	Group Practice or individual's zip code (9 digits when available)
Phone Number	9085423007
	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