Physician Compare National (NPI:1851360424)

HEALTHCARE PROVIDER: MARK JOSEPH ROY III OD

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

Individual Professional Information
NPI	1851360424
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	3678768744
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20120127000191
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	ROY
	Individual professional last name
Provider First Name	MARK
	Individual professional first name
Provider Middle Name	J
	Individual professional middle name
Provider Name Suffix Text	III
	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	SOUTHERN COLLEGE OF OPTOMETRY
	Individual professional's medical school
Graduation Year	2002
	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	640 SAINT CHARLES ST
	Group Practice or individual's line 1 address
City	THIBODAUX
	Group Practice or individual's city
State	LA
	Group Practice or individual's state
Zip Code	703013422
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y