Physician Compare National (NPI:1467719880)

HEALTHCARE PROVIDER: WILLIAM LUKE BLACKBURN D.C.

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

Individual Professional Information
NPI	1467719880
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	1557523461
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20150519002403
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	BLACKBURN
	Individual professional last name
Provider First Name	WILLIAM
	Individual professional first name
Provider Middle Name	LUKE
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	PALMER COLLEGE CHIROPRACTIC - DAVENPORT
	Individual professional's medical school
Graduation Year	2011
	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	1311 HARLAN DR
	Group Practice or individual's line 1 address
City	BELLEVUE
	Group Practice or individual's city
State	NE
	Group Practice or individual's state
Zip Code	680053647
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y