Physician Compare National (NPI:1750582458)

HEALTHCARE PROVIDER: DON TUAN WYNN 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	1750582458
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	3274633847
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20161227000220
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	WYNN
	Individual professional last name
Provider First Name	DON
	Individual professional first name
Provider Middle Name	T
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	MEDICAL COLLEGE OF GEORGIA SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	2001
	Individual professional's medical school graduation year
Primary Specialty	INTERNAL MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	PULMONARY DISEASE
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	PULMONARY DISEASE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	1800 W UNIVERSITY BLVD
	Group Practice or individual's line 1 address
City	DURANT
	Group Practice or individual's city
State	OK
	Group Practice or individual's state
Zip Code	747013006
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	450324
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	TEXOMA MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	370014
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	ALLIANCEHEALTH DURANT
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	371300
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	ATOKA COUNTY MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	670076
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	BAYLOR SCOTT AND WHITE SURGICAL HOSPITAL AT SHERMA
	Legal business name of hospital where individual professional provides service 4
Professional Accepts Medicare Assignment	Y