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General NPI Number Information
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NPI Number | 1437190790
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Entity Type | Individual
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Provider Name | JESSICA BEATRICE CAMPBELL
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Gender | Female
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Dates
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Enumeration Date | 06/09/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1246 ASHLAND AVE SUITE 101
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City | ZANESVILLE
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State | OH
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Zip | 43701-2861
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Country | US
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Telephone | 740-453-0730
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Fax |
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Provider Business Mailing Address
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Address Line | 1246 ASHLAND AVE SUITE 101
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City | ZANESVILLE
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State | OH
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Zip | 43701-2861
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Country | US
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Telephone | 740-453-0730
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | 057773
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License Number State | OH
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