Physician Compare National (NPI:1720216955)

HEALTHCARE PROVIDER: DEGAIL JAMAR HADLEY D.O.

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

Individual Professional Information
NPI	1720216955
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4284882408
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20130411000006
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	HADLEY
	Individual professional last name
Provider First Name	DEGAIL
	Individual professional first name
Provider Middle Name	JAMAR
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	2009
	Individual professional's medical school graduation year
Primary Specialty	FAMILY MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	700 E SUNFLOWER RD
	Group Practice or individual's line 1 address
City	CLEVELAND
	Group Practice or individual's city
State	MS
	Group Practice or individual's state
Zip Code	387322726
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	251318
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	NORTH SUNFLOWER MEDICAL CENTER CAH
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	250093
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	BOLIVAR MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	250082
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	DELTA REGIONAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	250099
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	GREENWOOD LEFLORE HOSPITAL
	Legal business name of hospital where individual professional provides service 4
Hospital Affiliation CCN 5	250152
	Medicare CCN of hospital where individual professional provides service 5
Hospital Affiliation LBN 5	MISSISSIPPI METHODIST REHAB CTR
	Legal business name of hospital where individual professional provides service 5
Professional Accepts Medicare Assignment	Y

Physician Compare National (NPI:1720216955)

HEALTHCARE PROVIDER: DEGAIL JAMAR HADLEY D.O.

Individual Professional Information

Medical School Information

Practice Information

Hospital(s) Affiliation Information