Physician Compare National (NPI:1558476739)

HEALTHCARE PROVIDER: BRADLEY WILLIAM BUCKROP DPM

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

Individual Professional Information
NPI	1558476739
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	3476672544
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20110622000063
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	BUCKROP
	Individual professional last name
Provider First Name	BRADLEY
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	COLLEGE OF PODIATRIC MED AND SURGERY, DES MOINES UNIVERSITY
	Individual professional's medical school
Graduation Year	1991
	Individual professional's medical school graduation year
Primary Specialty	PODIATRY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	3727 46TH AVE
	Group Practice or individual's line 1 address
Marker of address line 2 suppression	Y
	Marker that address as reported may be incomplete
City	ROCK ISLAND
	Group Practice or individual's city
State	IL
	Group Practice or individual's state
Zip Code	612017078
	Group Practice or individual's zip code (9 digits when available)
Phone Number	3097883668
	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