Physician Compare National (NPI:1679577258)

HEALTHCARE PROVIDER: DARRELL ALLEN SORAH JR. OD

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

Individual Professional Information
NPI	1679577258
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	6608879580
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20111107000583
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	SORAH
	Individual professional last name
Provider First Name	DARRELL
	Individual professional first name
Provider Middle Name	A
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	SOUTHERN COLLEGE OF OPTOMETRY
	Individual professional's medical school
Graduation Year	1995
	Individual professional's medical school graduation year
Primary Specialty	OPTOMETRY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	WINDER EYE CARE CENTER
	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	1153312871
	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	90 CHURCH ST
	Group Practice or individual's line 1 address
City	WINDER
	Group Practice or individual's city
State	GA
	Group Practice or individual's state
Zip Code	306801714
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y