Physician Compare National (NPI:1528418977)

HEALTHCARE PROVIDER: KYLE ANDREW STOTT O.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	1528418977
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	1658659057
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20190325000551
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	STOTT
	Individual professional last name
Provider First Name	KYLE
	Individual professional first name
Provider Middle Name	ANDREW
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	SOUTHERN COLLEGE OF OPTOMETRY
	Individual professional's medical school
Graduation Year	2012
	Individual professional's medical school graduation year
Primary Specialty	OPTOMETRY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	JOHN H MCDOUGALL OD ARIZONA PC
	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	3274880117
	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	21
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	3592 S ATHERTON BLVD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 111
	Group Practice or individual's line 2 address
City	GILBERT
	Group Practice or individual's city
State	AZ
	Group Practice or individual's state
Zip Code	852977444
	Group Practice or individual's zip code (9 digits when available)
Phone Number	4809884131
	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