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NPI Code Detail

MEDICARE: JULIE YOUNG CAMPBELL OD

MEDICARE: JULIE YOUNG CAMPBELL OD
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
1152W00000XOptometristOPC2920FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
120661OTHERFLBCBS

General Provider Information

NPI Number : 1669510111
Entity Type Code : Individual
Provider Name (Legal Business Name) : JULIE YOUNG CAMPBELL OD
Provider Business Mailing Address
First Line : 725 N TYNDALL PKWY
Second Line :
City : PANAMA CITY
State : FL
Zip : 32404-3219
Country : US
Telephone Number : 850-785-3426
Fax Number : 850-785-6556
Provider Business Practice Location Address
First Line : 725 N TYNDALL PKWY
Second Line :
City : PANAMA CITY
State : FL
Zip : 32404-3219
Country : US
Telephone Number : 850-785-3426
Fax Number : 850-785-6556
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/04/2007
Last Update Date : 07/08/2007

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Directions to “ JULIE YOUNG CAMPBELL OD” Practice Location

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