Physician Compare National (NPI:1346297694)

HEALTHCARE PROVIDER: SELMA P WILSON 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	1346297694
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	5395835672
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20101216001135
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	WILSON
	Individual professional last name
Provider First Name	SELMA
	Individual professional first name
Provider Middle Name	P
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF NEW MEXICO SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	1981
	Individual professional's medical school graduation year
Primary Specialty	INTERVENTIONAL PAIN MANAGEMENT
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	ANESTHESIOLOGY
	First secondary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 2	PAIN MANAGEMENT
	Second secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	ANESTHESIOLOGY, PAIN MANAGEMENT
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	10905 QUAKER AVE
	Group Practice or individual's line 1 address
City	LUBBOCK
	Group Practice or individual's city
State	TX
	Group Practice or individual's state
Zip Code	794248315
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	450162
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	GRACE MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	450876
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	LUBBOCK HEART HOSPITAL LP
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	450040
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	COVENANT MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	Y