Physician Compare National (NPI:1902984776)

HEALTHCARE PROVIDER: DOUGLAS A. HADLEY 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	1902984776
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	5597945287
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20151125000652
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	HADLEY
	Individual professional last name
Provider First Name	DOUGLAS
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	LOYOLA UNIVERSITY OF CHICAGO, STRITCH SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	1996
	Individual professional's medical school graduation year
Primary Specialty	INTERVENTIONAL RADIOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	INTERCITY RADIOLOGY PC
	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	9830003847
	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	35
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	915 HIGHLAND BLVD
	Group Practice or individual's line 1 address
City	BOZEMAN
	Group Practice or individual's city
State	MT
	Group Practice or individual's state
Zip Code	597156902
	Group Practice or individual's zip code (9 digits when available)
Phone Number	40658786311003
	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	270057
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	BOZEMAN HEALTH DEACONESS HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	271318
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	BARRETT HOSPITAL & HEALTHCARE
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	271389
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	271329
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	MADISON VALLEY MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 4
Hospital Affiliation CCN 5	271319
	Medicare CCN of hospital where individual professional provides service 5
Hospital Affiliation LBN 5	RUBY VALLEY HOSPITAL
	Legal business name of hospital where individual professional provides service 5
Professional Accepts Medicare Assignment	Y

Physician Compare National (NPI:1902984776)

HEALTHCARE PROVIDER: DOUGLAS A. HADLEY MD

Individual Professional Information

Medical School Information

Practice Information

Hospital(s) Affiliation Information