Physician Compare National (NPI:1629169065)

HEALTHCARE PROVIDER: JACK DINGLE M.D.

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

Individual Professional Information
NPI	1629169065
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4486683943
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20100701000126
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	DINGLE
	Individual professional last name
Provider First Name	JACK
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OHIO STATE UNIVERSITY COLLEGE OF MEDICINE
	Individual professional's medical school
Graduation Year	1972
	Individual professional's medical school graduation year
Primary Specialty	OPHTHALMOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	CENTRAL OHIO EYE PHYSICIANS AND SURGEONS INC
	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	0042249500
	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	3
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	262 NEIL AVE
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 420
	Group Practice or individual's line 2 address
City	COLUMBUS
	Group Practice or individual's city
State	OH
	Group Practice or individual's state
Zip Code	432157312
	Group Practice or individual's zip code (9 digits when available)
Phone Number	6142244297
	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