Physician Compare National (NPI:1942396718)

HEALTHCARE PROVIDER: CLIFFORD ROBERT POPLAR 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	1942396718
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	5294801130
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20080829000234
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	POPLAR
	Individual professional last name
Provider First Name	CLIFFORD
	Individual professional first name
Provider Middle Name	R
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1984
	Individual professional's medical school graduation year
Primary Specialty	INTERNAL MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	915 E GENEVA ST
	Group Practice or individual's line 1 address
City	DELAVAN
	Group Practice or individual's city
State	WI
	Group Practice or individual's state
Zip Code	531151922
	Group Practice or individual's zip code (9 digits when available)
Phone Number	2627282651
	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	520102
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	AURORA LAKELAND MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	520059
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	AURORA MEMORIAL HOSPITAL BURLINGTON
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	521357
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	MERCY WALWORTH HOSPITAL & MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	Y