Physician Compare National (NPI:1346345154)

HEALTHCARE PROVIDER: BOWDOIN GRAYSON SMITH 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	1346345154
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	0648242339
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20080111000352
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	SMITH
	Individual professional last name
Provider First Name	BOWDOIN
	Individual professional first name
Provider Middle Name	G
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	AT STILL UNIVERSITY OF HEALTH SCIENCES, COLLEGE OF OSTEO MED, KIRKSVILLE
	Individual professional's medical school
Graduation Year	1986
	Individual professional's medical school graduation year
Primary Specialty	EMERGENCY MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	OSTEOPATHIC MANIPULATIVE MEDICINE
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	OSTEOPATHIC MANIPULATIVE MEDICINE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	9 MAGGART CIR
	Group Practice or individual's line 1 address
City	CARTHAGE
	Group Practice or individual's city
State	TN
	Group Practice or individual's state
Zip Code	370302151
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	441307
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	RIVERVIEW REGIONAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	440187
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	LIVINGSTON REGIONAL HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y