Physician Compare National (NPI:1538250147)

HEALTHCARE PROVIDER: WILLIAM H HANEY MD

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

Individual Professional Information
NPI	1538250147
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	7113055096
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20101026001613
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	HANEY
	Individual professional last name
Provider First Name	WILLIAM
	Individual professional first name
Provider Middle Name	H
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	JC EDWARDS SCHOOL OF MEDICINE, MARSHALL UNIVERSITY
	Individual professional's medical school
Graduation Year	1986
	Individual professional's medical school graduation year
Primary Specialty	INTERNAL MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	PEDIATRIC MEDICINE
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	PEDIATRIC MEDICINE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	125 FAIRFAX AVE
	Group Practice or individual's line 1 address
City	LOUISVILLE
	Group Practice or individual's city
State	KY
	Group Practice or individual's state
Zip Code	402074905
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	180130
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	BAPTIST HEALTH LOUISVILLE
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	180040
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	JEWISH HOSPITAL & ST MARY'S HEALTHCARE
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y