Physician Compare National (NPI:1306815121)

HEALTHCARE PROVIDER:

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

Individual Professional Information
NPI	1306815121
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	1355428103
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20080404000168
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	DOHN
	Individual professional last name
Provider First Name	CARL
	Individual professional first name
Provider Middle Name	W
	Individual professional middle name
Provider Name Suffix Text	JR.
	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	MEDICAL COLLEGE OF GEORGIA SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	1975
	Individual professional's medical school graduation year
Primary Specialty	OBSTETRICS/GYNECOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	2320 HERON ST
	Group Practice or individual's line 1 address
City	BRUNSWICK
	Group Practice or individual's city
State	GA
	Group Practice or individual's state
Zip Code	315204239
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	110025
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	SOUTHEAST GEORGIA HEALTH SYSTEM- BRUNSWICK CAMPUS
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	M