Physician Compare National (NPI:1669630083)

HEALTHCARE PROVIDER: BENJAMIN OSBORN HENKLE 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	1669630083
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	1658565635
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20101103001020
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	HENKLE
	Individual professional last name
Provider First Name	BENJAMIN
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	INDIANA UNIVERSITY SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	2004
	Individual professional's medical school graduation year
Primary Specialty	PAIN MANAGEMENT
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	2 HOSPITAL DR
	Group Practice or individual's line 1 address
City	LOWELL
	Group Practice or individual's city
State	MA
	Group Practice or individual's state
Zip Code	018521311
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	220063
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	LOWELL GENERAL HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	M