Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN1001X | Nutrition | 008190 | NY |
NPI | 1538231840 |
---|---|
Provider Name | Dr. Joseph M Campbell |
First Address | Naples, NY 14512-0220 |
Second Address | Naples, NY 14512-9293 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/11/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U61588 | (02) |