Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0105X | Surgery of the Hand | H7941 | TX |
NPI | 1467440628 |
---|---|
Provider Name | Mr. John Thomas Camp |
First Address | Dallas, TX 75261-0307 |
Second Address | Tyler, TX 75701-8336 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/10/2005 |
Last Update Date | 06/05/2020 |