Physician Compare National (NPI:1750675658)

HEALTHCARE PROVIDER: BRADLEY JOHN MONTGOMERY D.C.

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

Individual Professional Information
NPI	1750675658
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	8921277328
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20110801000464
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	MONTGOMERY
	Individual professional last name
Provider First Name	BRADLEY
	Individual professional first name
Provider Middle Name	J.
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	CLEVELAND CHIROPRACTIC COLLEGE - KANSAS CITY
	Individual professional's medical school
Graduation Year	2011
	Individual professional's medical school graduation year
Primary Specialty	CHIROPRACTIC
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	817 W WALNUT AVE
	Group Practice or individual's line 1 address
City	DUNCAN
	Group Practice or individual's city
State	OK
	Group Practice or individual's state
Zip Code	735334621
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	370023
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	DUNCAN REGIONAL HOSPITAL, INC
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y