Physician Compare National (NPI:1639465719)

HEALTHCARE PROVIDER: CHET ALVIS CRAWFORD 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	1639465719
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	8426294158
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20130424000782
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	CRAWFORD
	Individual professional last name
Provider First Name	CHET
	Individual professional first name
Provider Middle Name	ALVIS
	Individual professional middle name
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	2011
	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
Organization Legal Name	CORRECT CARE, 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	8628980992
	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	42
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	451 W LOCKE ST
	Group Practice or individual's line 1 address
Line 2 Street Address	LITTLE RIVER MEMORIAL HOSPITAL
	Group Practice or individual's line 2 address
City	ASHDOWN
	Group Practice or individual's city
State	AR
	Group Practice or individual's state
Zip Code	718223325
	Group Practice or individual's zip code (9 digits when available)
Phone Number	8708985011
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	041320
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	LITTLE RIVER MEMORIAL HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y