Physician Compare National (NPI:1700944121)

HEALTHCARE PROVIDER: CHARLES JOHN TUPPER JR. 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	1700944121
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	6507995495
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20100602000928
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	TUPPER
	Individual professional last name
Provider First Name	CHARLES
	Individual professional first name
Provider Middle Name	JOHN
	Individual professional middle name
Provider Name Suffix Text	JR.
	The name suffix of the provider if the provider is an individual. The name suffix is a ''generation-related'' suffix, such as Jr., Sr., II, III, IV, or V.
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF TEXAS MEDICAL SCHOOL AT SAN ANTONIO
	Individual professional's medical school
Graduation Year	1987
	Individual professional's medical school graduation year
Primary Specialty	PSYCHIATRY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	AWARE INC
	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	4284529348
	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	616 HELENA AVE
	Group Practice or individual's line 1 address
Line 2 Street Address	305 AWARE SUPPORT SVCS HELENA
	Group Practice or individual's line 2 address
City	HELENA
	Group Practice or individual's city
State	MT
	Group Practice or individual's state
Zip Code	596013654
	Group Practice or individual's zip code (9 digits when available)
Phone Number	4064493120
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y