Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | 01071425A | IN |
NPI | 1225019516 |
---|---|
Provider Name | Mrs. Linda A Camp |
First Address | Salem, OH 44460-4409 |
Second Address | Muncie, IN 47304-3988 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/11/2005 |
Last Update Date | 11/02/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1326268202 | GROUP NPI (01) | IL |
201080210 | MEDICAID (01) | IN |
36119449 | (05) | IL |
P01120501 | RAILROAD MEDICARE (01) | IN |