Physician Compare National (NPI:1578794483)

HEALTHCARE PROVIDER: WALTER H STUART IV CRNA

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

Individual Professional Information
NPI	1578794483
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	0547308306
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20200313001482
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	STUART
	Individual professional last name
Provider First Name	WALTER
	Individual professional first name
Provider Middle Name	H
	Individual professional middle name
Provider Name Suffix Text	IV
	The name suffix of the provider if the provider is an individual. The name suffix is a ''generation-related'' suffix, such as Jr., Sr., II, III, IV, or V.
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	2009
	Individual professional's medical school graduation year
Primary Specialty	CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	LIFELINC ANESTHESIA V, P.A.
	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	8921359712
	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	28
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	303 W POLK AVE
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE A
	Group Practice or individual's line 2 address
City	WEST MEMPHIS
	Group Practice or individual's city
State	AR
	Group Practice or individual's state
Zip Code	723014235
	Group Practice or individual's zip code (9 digits when available)
Phone Number	8707322100
	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