Physician Compare National (NPI:1619059037)

HEALTHCARE PROVIDER: PAUL OBRIEN MCKESEY 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	1619059037
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	9335212885
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20080717000160
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	MCKESEY
	Individual professional last name
Provider First Name	PAUL
	Individual professional first name
Provider Middle Name	O
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	MEDICAL COLLEGE OF PENNSYLVANIA
	Individual professional's medical school
Graduation Year	1998
	Individual professional's medical school graduation year
Primary Specialty	GENERAL SURGERY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	700 W CENTRAL AVE
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 406
	Group Practice or individual's line 2 address
City	EL DORADO
	Group Practice or individual's city
State	KS
	Group Practice or individual's state
Zip Code	670422116
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	170017
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	SUSAN B ALLEN MEMORIAL HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	171339
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	GREENWOOD COUNTY HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y