Physician Compare National (NPI:1962660688)

HEALTHCARE PROVIDER: MISTY QUINN BRANAM D.O.

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

Individual Professional Information
NPI	1962660688
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	8527251644
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20101021000998
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	BRANAM
	Individual professional last name
Provider First Name	MISTY
	Individual professional first name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	2010
	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
Organization Legal Name	MCALESTER MEDICAL SERVICES LLC
	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	9931139029
	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	36
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	4 E CLARK BASS BLVD
	Group Practice or individual's line 1 address
Line 2 Street Address	301C SOUTHEAST CLINIC INTERNAL MEDICINE
	Group Practice or individual's line 2 address
City	MCALESTER
	Group Practice or individual's city
State	OK
	Group Practice or individual's state
Zip Code	745014269
	Group Practice or individual's zip code (9 digits when available)
Phone Number	9184218966
	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	370034
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	MCALESTER REGIONAL HEALTH CENTER AUTHORITY
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y