Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 144276 | NY |
N | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 144276 | NY |
NPI | 1427085216 |
---|---|
Provider Name | Thomas L Campbell |
First Address | Rochester, NY 14620-1401 |
Second Address | Rochester, NY 14620-1401 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2006 |
Last Update Date | 01/07/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B72209 | (02) | NY |