Physician Compare National (NPI:1689065559)

HEALTHCARE PROVIDER: PHILLIP BARRETT CORONA D.P.M

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

Individual Professional Information
NPI	1689065559
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	5092026906
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20150618002584
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	CORONA
	Individual professional last name
Provider First Name	PHILLIP
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	KENT STATE UNIVERSITY COLLEGE OF PODIATRIC MEDICINE
	Individual professional's medical school
Graduation Year	2012
	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	970 S ACADIA RD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE C
	Group Practice or individual's line 2 address
City	THIBODAUX
	Group Practice or individual's city
State	LA
	Group Practice or individual's state
Zip Code	703014978
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y