Physician Compare National (NPI:1386636314)

HEALTHCARE PROVIDER: LANCE EUGENE FORD 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	1386636314
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	5294850129
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20100916000219
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	FORD
	Individual professional last name
Provider First Name	LANCE
	Individual professional first name
Provider Middle Name	EUGENE
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	CLEVELAND CHIROPRACTIC COLLEGE - KANSAS CITY
	Individual professional's medical school
Graduation Year	1989
	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	612 S MAIN ST
	Group Practice or individual's line 1 address
City	CARTHAGE
	Group Practice or individual's city
State	MO
	Group Practice or individual's state
Zip Code	648361649
	Group Practice or individual's zip code (9 digits when available)
Phone Number	4173583201
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	261338
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	MERCY HOSPITAL CARTHAGE
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y