Physician Compare National (NPI:1861402588)

HEALTHCARE PROVIDER: NACONDUS G GAMBLE OPTOMETRIST

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

Individual Professional Information
NPI	1861402588
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4880693571
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20080902000285
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	GAMBLE
	Individual professional last name
Provider First Name	NACONDUS
	Individual professional first name
Provider Middle Name	G
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	PENNSYLVANIA COLLEGE OF OPTOMETRY
	Individual professional's medical school
Graduation Year	2006
	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	175 S RAILROAD ST
	Group Practice or individual's line 1 address
City	PEMBROKE
	Group Practice or individual's city
State	GA
	Group Practice or individual's state
Zip Code	313215744
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y