Physician Compare National (NPI:1649474032)

HEALTHCARE PROVIDER: TOM TIEN DANG DPM

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

Individual Professional Information
NPI	1649474032
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	6901839612
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20050914000068
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	DANG
	Individual professional last name
Provider First Name	TOM
	Individual professional first name
Provider Middle Name	T
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.
Provider Credential Text	DPM
	The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information
Medical School Name	DES MOINES UNIVERSITY OF OSTEOPATHIC MEDICINE AND HEALTH SCIENCES
	Individual professional's medical school
Graduation Year	1996
	Individual professional's medical school graduation year
Primary Specialty	PODIATRY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	1105 E MAIN ST
	Group Practice or individual's line 1 address
City	ROYSTON
	Group Practice or individual's city
State	GA
	Group Practice or individual's state
Zip Code	306623803
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	110027
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	TY COBB REGIONAL MEDICAL CENTER, LLC
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	110074
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	PIEDMONT ATHENS REGIONAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y