Physician Compare National (NPI:1376616664)

HEALTHCARE PROVIDER: HEATHER BOND SOUTHARD DDS

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

Individual Professional Information
NPI	1376616664
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	9335364702
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20160104001388
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	SOUTHARD
	Individual professional last name
Provider First Name	HEATHER
	Individual professional first name
Provider Middle Name	BOND
	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 TENNESSEE HSC COLLEGE OF DENTISTRY
	Individual professional's medical school
Graduation Year	2002
	Individual professional's medical school graduation year
Primary Specialty	ORAL SURGERY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	2600 BROWNS LN
	Group Practice or individual's line 1 address
Line 2 Street Address	B
	Group Practice or individual's line 2 address
City	JONESBORO
	Group Practice or individual's city
State	AR
	Group Practice or individual's state
Zip Code	724017226
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y