Physician Compare National (NPI:1801869185)

HEALTHCARE PROVIDER: TIMOTHY WAYNE YAWN MD

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

Individual Professional Information
NPI	1801869185
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4385795848
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20090624000362
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	YAWN
	Individual professional last name
Provider First Name	TIMOTHY
	Individual professional first name
Provider Middle Name	W
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF ARKANSAS COLLEGE OF MEDICINE
	Individual professional's medical school
Graduation Year	1988
	Individual professional's medical school graduation year
Primary Specialty	FAMILY MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	1615 W PERSIMMON ST B
	Group Practice or individual's line 1 address
City	ROGERS
	Group Practice or individual's city
State	AR
	Group Practice or individual's state
Zip Code	727563383
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	040022
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	NORTHWEST MEDICAL CENTER-SPRINGDALE
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	040010
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	MERCY HOSPITAL NORTHWEST ARKANSAS
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	M