Physician Compare National (NPI:1700814647)

HEALTHCARE PROVIDER: JERRY LEE LUGGER 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	1700814647
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	3971766700
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20120515000398
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	LUGGER
	Individual professional last name
Provider First Name	JERRY
	Individual professional first name
Provider Middle Name	L
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OHIO STATE UNIVERSITY COLLEGE OF MEDICINE
	Individual professional's medical school
Graduation Year	1972
	Individual professional's medical school graduation year
Primary Specialty	PLASTIC AND RECONSTRUCTIVE SURGERY
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	HAND SURGERY
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	HAND SURGERY
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	3061 W SOUTHLAKE BLVD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 130
	Group Practice or individual's line 2 address
City	SOUTHLAKE
	Group Practice or individual's city
State	TX
	Group Practice or individual's state
Zip Code	760920311
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y