Physician Compare National (NPI:1528118460)

HEALTHCARE PROVIDER: JESSE ALLEN COFFEY JR. 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	1528118460
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	7517016488
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20171219001543
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	COFFEY
	Individual professional last name
Provider First Name	JESSE
	Individual professional first name
Provider Middle Name	ALLEN
	Individual professional middle name
Provider Name Suffix Text	JR.
	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.

Medical School Information
Medical School Name	BAYLOR COLLEGE OF MEDICINE
	Individual professional's medical school
Graduation Year	1984
	Individual professional's medical school graduation year
Primary Specialty	PLASTIC AND RECONSTRUCTIVE SURGERY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	WYOMING HEALTH MEDICAL GROUP LLC
	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	8426102831
	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	54
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	419 S WASHINGTON ST
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 201
	Group Practice or individual's line 2 address
City	CASPER
	Group Practice or individual's city
State	WY
	Group Practice or individual's state
Zip Code	826012951
	Group Practice or individual's zip code (9 digits when available)
Phone Number	3072375026
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y