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NPI Code Detail

MEDICARE: DR. STEPHANIE JULIET CAMPBELL DO

MEDICARE:  DR. STEPHANIE JULIET CAMPBELL  DO
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
1390200000XStudent in an Organized Health Care Education/Training Program
2207N00000XDermatology PhysicianDO189847OR

General Provider Information

NPI Number : 1588957864
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. STEPHANIE JULIET CAMPBELL DO
Provider Business Mailing Address
First Line : 706 NE EVANS ST
Second Line :
City : MCMINNVILLE
State : OR
Zip : 97128-3926
Country : US
Telephone Number : 503-472-1405
Fax Number : 503-472-1405
Provider Business Practice Location Address
First Line : 706 NE EVANS ST
Second Line :
City : MCMINNVILLE
State : OR
Zip : 97128-3926
Country : US
Telephone Number : 503-472-1405
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/19/2011
Last Update Date : 06/16/2022

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Directions to “ DR. STEPHANIE JULIET CAMPBELL DO” Practice Location

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