Physician Compare National (NPI:1487712808)

HEALTHCARE PROVIDER: ADEDAPO ADEYEMI ODUYE 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	1487712808
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	1850482530
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20070809000507
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	ODUYE
	Individual professional last name
Provider First Name	ADEDAPO
	Individual professional first name
Provider Middle Name	ADEYEMI
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	2002
	Individual professional's medical school graduation year
Primary Specialty	EMERGENCY MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	FAMILY MEDICINE
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	FAMILY MEDICINE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Organization Legal Name	PEMISCOT COUNTY MEMORIAL HOSPITAL
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	8426024159
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	22
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	946 E REED ST
	Group Practice or individual's line 1 address
City	HAYTI
	Group Practice or individual's city
State	MO
	Group Practice or individual's state
Zip Code	638511243
	Group Practice or individual's zip code (9 digits when available)
Phone Number	5733593659
	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	010006
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	ELIZA COFFEE MEMORIAL HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	260180
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	CHRISTIAN HOSPITAL NORTHEAST
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	010164
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	COOSA VALLEY MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	260070
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	PEMISCOT COUNTY MEMORIAL HOSPITAL
	Legal business name of hospital where individual professional provides service 4
Professional Accepts Medicare Assignment	Y