Physician Compare National (NPI:1326180084)

HEALTHCARE PROVIDER: WALTER RAY KLASSEN MD

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

Individual Professional Information
NPI	1326180084
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	6305999137
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20090727000657
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	KLASSEN
	Individual professional last name
Provider First Name	WALTER
	Individual professional first name
Provider Middle Name	R
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	2006
	Individual professional's medical school graduation year
Primary Specialty	FAMILY MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	1024 MAIN ST
	Group Practice or individual's line 1 address
City	WOODWARD
	Group Practice or individual's city
State	OK
	Group Practice or individual's state
Zip Code	738013120
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	370002
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	ALLIANCEHEALTH WOODWARD
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	370093
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	OU MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y