Physician Compare National (NPI:1962635185)

HEALTHCARE PROVIDER: HAROLD SHANE BROWN DPM

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

Individual Professional Information
NPI	1962635185
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	8123294923
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20120820000801
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	BROWN
	Individual professional last name
Provider First Name	HAROLD
	Individual professional first name
Provider Middle Name	SHANE
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	MID WEST MEDICAL COLLEGE
	Individual professional's medical school
Graduation Year	2009
	Individual professional's medical school graduation year
Primary Specialty	PODIATRY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	FANNIN COUNTY HOSPITAL AUTHORITY
	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	6002054764
	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	2
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	1211 E 6TH ST
	Group Practice or individual's line 1 address
Marker of address line 2 suppression	Y
	Marker that address as reported may be incomplete
City	BONHAM
	Group Practice or individual's city
State	TX
	Group Practice or individual's state
Zip Code	754184095
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	451370
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	TMC- BONHAM HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	450324
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	TEXOMA MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y