Physician Compare National (NPI:1386110385)

HEALTHCARE PROVIDER: CHASE DUDLEY DC

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

Individual Professional Information
NPI	1386110385
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	7719217454
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20190924001363
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	DUDLEY
	Individual professional last name
Provider First Name	CHASE
	Individual professional first name
Provider Middle Name	D
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	LIFE CHIROPRACTIC COLLEGE - WEST
	Individual professional's medical school
Graduation Year	2018
	Individual professional's medical school graduation year
Primary Specialty	CHIROPRACTIC
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	7960 W RIFLEMAN ST
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 160
	Group Practice or individual's line 2 address
City	BOISE
	Group Practice or individual's city
State	ID
	Group Practice or individual's state
Zip Code	837049065
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y