Physician Compare National (NPI:1841678109)

HEALTHCARE PROVIDER: LEONARD HERBERT OTWORTH IV D.O.

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

Individual Professional Information
NPI	1841678109
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	8820301203
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20161118000973
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	OTWORTH
	Individual professional last name
Provider First Name	LEONARD
	Individual professional first name
Provider Middle Name	HERBERT
	Individual professional middle name
Provider Name Suffix Text	IV
	The name suffix of the provider if the provider is an individual. The name suffix is a ''generation-related'' suffix, such as Jr., Sr., II, III, IV, or V.
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OHIO STATE UNIVERSITY COLLEGE OF MEDICINE
	Individual professional's medical school
Graduation Year	2015
	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
Organization Legal Name	ASHLAND HOSPITAL CORPORATION
	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	7719882521
	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	102
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	2001 SCIOTO TRL
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 300
	Group Practice or individual's line 2 address
City	PORTSMOUTH
	Group Practice or individual's city
State	OH
	Group Practice or individual's state
Zip Code	456625122
	Group Practice or individual's zip code (9 digits when available)
Phone Number	7403536390
	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	180009
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	KING'S DAUGHTERS' MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	360361
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	KINGS DAUGHTERS MEDICAL CENTER OHIO
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	360008
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	SOUTHERN OHIO MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	Y