Physician Compare National (NPI:1407941321)

HEALTHCARE PROVIDER: GILBERT RUSSELL LADD IV 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	1407941321
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	1557367844
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20061010000323
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	LADD
	Individual professional last name
Provider First Name	GILBERT
	Individual professional first name
Provider Middle Name	RUSSELL
	Individual professional middle name
Provider Name Suffix Text	IV
	The name suffix of the provider if the provider is an individual. The name suffix is a ''generation-related'' suffix, such as Jr., Sr., II, III, IV, or V.
Provider Gender	M
	The provider's gender if the provider is a person.
Provider Credential Text	MD
	The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information
Medical School Name	VANDERBILT UNIVERSITY SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	1991
	Individual professional's medical school graduation year
Primary Specialty	PSYCHIATRY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	3290 W BIG BEAVER RD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 509
	Group Practice or individual's line 2 address
City	TROY
	Group Practice or individual's city
State	MI
	Group Practice or individual's state
Zip Code	480842917
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y