Physician Compare National (NPI:1295762136)

HEALTHCARE PROVIDER: LLOYD J. BEAUDRY D.O.

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

Individual Professional Information
NPI	1295762136
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	8022202357
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20101101000884
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	BEAUDRY
	Individual professional last name
Provider First Name	LLOYD
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	MIDWESTERN UNIVERSITY, CHICAGO COLLEGE OF OSTEOPATHIC MED
	Individual professional's medical school
Graduation Year	1988
	Individual professional's medical school graduation year
Primary Specialty	GENERAL SURGERY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	3231 W RD
	Group Practice or individual's line 1 address
City	TRENTON
	Group Practice or individual's city
State	MI
	Group Practice or individual's state
Zip Code	481832399
	Group Practice or individual's zip code (9 digits when available)
Phone Number	7346923500
	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	230176
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	BEAUMONT HOSPITAL - TRENTON
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	230146
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	HENRY FORD WYANDOTTE HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	M