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General NPI Number Information
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NPI Number | 1043409758
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Entity Type | Organization
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Legal Business Name | KAMEL INC.
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Dates
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Enumeration Date | 10/18/2007
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Last Update Date | 10/15/2012
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Provider Practice Location Address
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Address Line | 3508 S LAFOUNTAIN ST
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City | KOKOMO
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State | IN
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Zip | 46902-3803
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Country | US
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Telephone | 765-864-5704
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Fax | 765-864-5720
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Provider Business Mailing Address
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Address Line | 3508 S LAFOUNTAIN ST
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City | KOKOMO
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State | IN
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Zip | 46902-3803
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Country | US
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Telephone | 765-864-5704
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Fax | 765-864-5720
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Authorized Official
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Title or Position | MANAGER
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Name | DR. ERIC J HEATHERS
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Credential | RN
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Telephone | 765-864-5704
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 01044350A
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License Number State | IN
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