MEDICARE: RICHARD JOHN CAMPEAU JR. MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207U00000X	Nuclear Medicine Physician	LA011223	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	01168432	OTHER	LA	LA CAID

General Provider Information

NPI Number	:	1023176989
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICHARD JOHN CAMPEAU JR. MD

Provider Business Mailing Address
First Line	:	5316 DRYADES ST
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70115-4947
Country	:	US
Telephone Number	:	504-897-4159
Fax Number	:	504-891-6727

Provider Business Practice Location Address
First Line	:	5316 DRYADES ST
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70115-4947
Country	:	US
Telephone Number	:	504-897-4159
Fax Number	:	504-891-6727

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/04/2006
Last Update Date	:	07/08/2007

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