Healthcare Provider Details

I. General information

NPI: 1770574899
Provider Name (Legal Business Name): RONALD JOHN CAMPBELL JR. PHRAM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 10/31/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

815 FREEPORT RD
PITTSBURGH PA
15215-3301
US

IV. Provider business mailing address

2918 KINGSTON CT
NORTH HUNTINGDON PA
15642-9633
US

V. Phone/Fax

Practice location:
  • Phone: 412-784-4956
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License NumberRP046179L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: