Healthcare Provider Details

I. General information

NPI: 1548352073
Provider Name (Legal Business Name): AMY C CAMPION DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2006
Last Update Date: 10/31/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

710 STOCKBRIDGE RD
LEE MA
01238-9316
US

IV. Provider business mailing address

710 STOCK BRIDGE RD
LEE MA
01238
US

V. Phone/Fax

Practice location:
  • Phone: 413-243-0122
  • Fax: 413-243-2251
Mailing address:
  • Phone: 413-243-0122
  • Fax: 413-243-2251

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number232349
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: