Physician Compare National (NPI:1891718177)

HEALTHCARE PROVIDER: MARK BARTON CHARBONNET 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	1891718177
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	9739374026
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20101111001565
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	CHARBONNET
	Individual professional last name
Provider First Name	MARK
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	LOUISIANA STATE UNIVERSITY SCHOOL OF MEDICINE IN NEW ORLEANS
	Individual professional's medical school
Graduation Year	1996
	Individual professional's medical school graduation year
Primary Specialty	GENERAL PRACTICE
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	MEDICAL ONCOLOGY
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	MEDICAL ONCOLOGY
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	602 N LEWIS ST
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 600
	Group Practice or individual's line 2 address
City	NEW IBERIA
	Group Practice or individual's city
State	LA
	Group Practice or individual's state
Zip Code	705632983
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	190064
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	OUR LADY OF THE LAKE REGIONAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	190054
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	IBERIA MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	190102
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	OUR LADY OF LOURDES REGIONAL MEDICAL CENTER, INC
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	Y