Physician Compare National (NPI:1740264662)

HEALTHCARE PROVIDER: DR. GEORGE WORTHY PEGRAM III

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

Individual Professional Information
NPI	1740264662
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	2466479852
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20090117000008
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	PEGRAM
	Individual professional last name
Provider First Name	GEORGE
	Individual professional first name
Provider Middle Name	W
	Individual professional middle name
Provider Name Suffix Text	III
	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	SOUTHERN COLLEGE OF OPTOMETRY
	Individual professional's medical school
Graduation Year	1992
	Individual professional's medical school graduation year
Primary Specialty	OPTOMETRY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	801 POINDEXTER ST
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 115
	Group Practice or individual's line 2 address
City	CHESAPEAKE
	Group Practice or individual's city
State	VA
	Group Practice or individual's state
Zip Code	233242358
	Group Practice or individual's zip code (9 digits when available)
Phone Number	7575453930
	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