Physician Compare National (NPI:1821081738)

HEALTHCARE PROVIDER: PAUL A. HENRIKSEN O.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	1821081738
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	7911046727
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20091207000640
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	HENRIKSEN
	Individual professional last name
Provider First Name	PAUL
	Individual professional first name
Provider Middle Name	A
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	ILLINOIS COLLEGE OF OPTOMETRY AT CHICAGO
	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	212 W MAIN ST
	Group Practice or individual's line 1 address
City	PIPESTONE
	Group Practice or individual's city
State	MN
	Group Practice or individual's state
Zip Code	561641634
	Group Practice or individual's zip code (9 digits when available)
Phone Number	5078255444
	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