Physician Compare National (NPI:1649232513)

HEALTHCARE PROVIDER: DALE BRYANT ELMORE 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	1649232513
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	2365611233
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20110810000263
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	ELMORE
	Individual professional last name
Provider First Name	DALE
	Individual professional first name
Provider Middle Name	BRYANT
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF SOUTH FLORIDA COLLEGE OF MEDICINE
	Individual professional's medical school
Graduation Year	1978
	Individual professional's medical school graduation year
Primary Specialty	OBSTETRICS/GYNECOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	417 E LAMAR ALEXANDER PKWY
	Group Practice or individual's line 1 address
City	MARYVILLE
	Group Practice or individual's city
State	TN
	Group Practice or individual's state
Zip Code	378045816
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	440011
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	BLOUNT MEMORIAL HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y