Physician Compare National (NPI:1396989786)

HEALTHCARE PROVIDER: NATHAN BRANTLEY WYATT M.D.

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

Individual Professional Information
NPI	1396989786
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	3274758222
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20140707000801
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	WYATT
	Individual professional last name
Provider First Name	NATHAN
	Individual professional first name
Provider Middle Name	BRANTLEY
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF SOUTH ALABAMA COLLEGE OF MEDICINE
	Individual professional's medical school
Graduation Year	2009
	Individual professional's medical school graduation year
Primary Specialty	NEUROLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	721 GLENWOOD DR
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 467
	Group Practice or individual's line 2 address
City	CHATTANOOGA
	Group Practice or individual's city
State	TN
	Group Practice or individual's state
Zip Code	374041154
	Group Practice or individual's zip code (9 digits when available)
Phone Number	4236983423
	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	440091
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	MEMORIAL HEALTHCARE SYSTEM, INC
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y