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General NPI Number Information
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NPI Number | 1255684262
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Entity Type | Organization
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Legal Business Name | JULIE YOUNG CAMPBELL OD LLC
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Dates
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Enumeration Date | 10/16/2012
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Last Update Date | 10/16/2012
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Provider Practice Location Address
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Address Line | 725 N TYNDALL PKWY
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City | CALLAWAY
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State | FL
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Zip | 32404-3219
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Country | US
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Telephone | 850-785-3426
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Fax | 850-785-6556
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Provider Business Mailing Address
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Address Line | 725 N TYNDALL PKWY
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City | CALLAWAY
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State | FL
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Zip | 32404-3219
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Country | US
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Telephone | 850-785-3426
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Fax | 850-785-6556
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. JULIE YOUNG CAMPBELL
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Credential | O.D.
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Telephone | 850-249-7300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OP2920
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License Number State | FL
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