Physician Compare National (NPI:1689637209)

HEALTHCARE PROVIDER: SANDRA JO HAZELIP DO

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

Individual Professional Information
NPI	1689637209
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	6800852153
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20041208000327
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	HAZELIP
	Individual professional last name
Provider First Name	SANDRA
	Individual professional first name
Provider Middle Name	J
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.
Provider Credential Text	DO
	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	OTHER
	Individual professional's medical school
Graduation Year	1984
	Individual professional's medical school graduation year
Primary Specialty	FAMILY MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	GERIATRIC MEDICINE
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	GERIATRIC MEDICINE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	700 S OSTROM AVE
	Group Practice or individual's line 1 address
City	EASTLAND
	Group Practice or individual's city
State	TX
	Group Practice or individual's state
Zip Code	764483226
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	450229
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	HENDRICK MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	450411
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	EASTLAND MEMORIAL HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	450558
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	ABILENE REGIONAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	Y