Healthcare Provider Details

I. General information

NPI: 1205742608
Provider Name (Legal Business Name): TRISTAN F CAMPELLONE HADS001025
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 MCEVER RD
GAINESVILLE GA
30504-5539
US

IV. Provider business mailing address

3000 MCEVER RD
GAINESVILLE GA
30504-5539
US

V. Phone/Fax

Practice location:
  • Phone: 678-696-5470
  • Fax:
Mailing address:
  • Phone: 678-696-5470
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberHADS001025
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: