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Physician Compare National (NPI:1992781710)

HEALTHCARE PROVIDER: QUINCY O SCOTT 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 1992781710
Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID 4587794946
Unique individual clinician ID assigned by PECOS
Professional Enrollment ID I20100610000772
Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name SCOTT
Individual professional last name
Provider First Name QUINCY
Individual professional first name
Provider Middle Name ONEAL
Individual professional middle name
Provider Name Suffix Text JR.
The name suffix of the provider if the provider is an individual. The name suffix is a ''generation-related'' suffix, such as Jr., Sr., II, III, IV, or V.
Provider Gender M
The provider's gender if the provider is a person.

Medical School Information

Medical School Name MIDWESTERN UNIVERSITY, CHICAGO COLLEGE OF OSTEOPATHIC MED
Individual professional's medical school
Graduation Year 1990
Individual professional's medical school graduation year
Primary Specialty FAMILY MEDICINE
Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information

Organization Legal Name SOUTHERN ILLINOIS HOSPITAL SERVICES
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 2961310966
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 6
Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address 2553 KEN GRAY BLVD
Group Practice or individual's line 1 address
City W FRANKFORT
Group Practice or individual's city
State IL
Group Practice or individual's state
Zip Code 628964174
Group Practice or individual's zip code (9 digits when available)
Phone Number 6189322155
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 140011
Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1 SOUTHERN ILLINOIS HOSPITAL SERVICES DBA HERRIN HOSPITAL
Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2 140164
Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2 MEMORIAL HOSPITAL OF CARBONDALE
Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment Y

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