Physician Compare National (NPI:1578542486)

HEALTHCARE PROVIDER: JEFFERY ALLEN TRAIL 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	1578542486
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	1759273238
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20101207000468
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	TRAIL
	Individual professional last name
Provider First Name	JEFFERY
	Individual professional first name
Provider Middle Name	A
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	VANDERBILT UNIVERSITY SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	1985
	Individual professional's medical school graduation year
Primary Specialty	FAMILY MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	42 E ROWAN AVE
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE A
	Group Practice or individual's line 2 address
City	SPOKANE
	Group Practice or individual's city
State	WA
	Group Practice or individual's state
Zip Code	992071212
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	500077
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	PROVIDENCE HOLY FAMILY HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	500054
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	PROVIDENCE SACRED HEART MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y