Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 33414 | CO |
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | DR.0033414 | CO |
NPI | 1740373190 |
---|---|
Provider Name | John Campana |
First Address | Aurora, CO 80042-0429 |
Second Address | Highlands Ranch, CO 80129-6949 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/09/2006 |
Last Update Date | 20/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F78699 | (02) | CO |