Healthcare Provider Details
I. General information
NPI: 1336338029
Provider Name (Legal Business Name): CAMDEN MEDICAL BLDG INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/18/2007
Last Update Date: 03/27/2024
Certification Date: 03/27/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
79 W CENTRAL AVE
CAMDEN OH
45311-1007
US
IV. Provider business mailing address
79 W CENTRAL AVE
CAMDEN OH
45311-1007
US
V. Phone/Fax
- Phone: 937-452-1201
- Fax: 937-452-0004
- Phone: 937-452-1201
- Fax: 937-452-0004
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JAMES
W
THOMSON
Title or Position: OWNER
Credential: DO
Phone: 937-452-1201