Physician Compare National (NPI:1912938754)

HEALTHCARE PROVIDER: MICHAEL B GUILLORY M.D.

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

Individual Professional Information
NPI	1912938754
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	9739135476
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20080602000679
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	GUILLORY
	Individual professional last name
Provider First Name	MICHAEL
	Individual professional first name
Provider Middle Name	B
	Individual professional middle 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	1977
	Individual professional's medical school graduation year
Primary Specialty	OPHTHALMOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	3209 N 4TH ST
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 100
	Group Practice or individual's line 2 address
City	LONGVIEW
	Group Practice or individual's city
State	TX
	Group Practice or individual's state
Zip Code	756055170
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y