Physician Compare National (NPI:1740321900)

HEALTHCARE PROVIDER: JERRY ALLEN RICHT OD

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

Individual Professional Information
NPI	1740321900
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	8426215401
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20120202000259
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	RICHT
	Individual professional last name
Provider First Name	JERRY
	Individual professional first name
Provider Middle Name	ALLEN
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY ALABAMA BIRMINGHAM - SCHOOL OF OPTOMETRY
	Individual professional's medical school
Graduation Year	1982
	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	76 MOUSE CREEK RD NW
	Group Practice or individual's line 1 address
City	CLEVELAND
	Group Practice or individual's city
State	TN
	Group Practice or individual's state
Zip Code	373124875
	Group Practice or individual's zip code (9 digits when available)
Phone Number	4234725085
	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