Physician Compare National (NPI:1760564793)

HEALTHCARE PROVIDER: JACKSON L FLANIGAN 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	1760564793
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	9638102148
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20101118001063
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	FLANIGAN
	Individual professional last name
Provider First Name	JACKSON
	Individual professional first name
Provider Middle Name	L
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	JC EDWARDS SCHOOL OF MEDICINE, MARSHALL UNIVERSITY
	Individual professional's medical school
Graduation Year	1991
	Individual professional's medical school graduation year
Primary Specialty	GENERAL SURGERY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	VASCULAR INSTITUTE OF COLUMBUS LLC
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	4789916248
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	2
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	6503 E BROAD ST
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 200
	Group Practice or individual's line 2 address
City	COLUMBUS
	Group Practice or individual's city
State	OH
	Group Practice or individual's state
Zip Code	432131693
	Group Practice or individual's zip code (9 digits when available)
Phone Number	6148101300
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	360203
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	SOUTHEASTERN OHIO REGIONAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y