Physician Compare National (NPI:1538111257)

HEALTHCARE PROVIDER: ERIC YANCEY PETERSON 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	1538111257
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	7810927118
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20100717000170
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	PETERSON
	Individual professional last name
Provider First Name	ERIC
	Individual professional first name
Provider Middle Name	Y
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	LOUISIANA STATE UNIVERSITY SCHOOL OF MEDICINE IN SHREVEPORT
	Individual professional's medical school
Graduation Year	1991
	Individual professional's medical school graduation year
Primary Specialty	OBSTETRICS/GYNECOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	RIO PECOS MEDICAL ASSOCIATES LTD
	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	5597746875
	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	5
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	509 W MAHONE DR
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE B
	Group Practice or individual's line 2 address
City	ARTESIA
	Group Practice or individual's city
State	NM
	Group Practice or individual's state
Zip Code	882102074
	Group Practice or individual's zip code (9 digits when available)
Phone Number	5757483675
	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