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General NPI Number Information
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NPI Number | 1447915277
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Entity Type | Organization
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Legal Business Name | THE CAMERON CLINIC PLLC
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Dates
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Enumeration Date | 11/05/2021
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Last Update Date | 02/07/2025
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Provider Practice Location Address
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Address Line | 3204 4TH ST
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City | LONGVIEW
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State | TX
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Zip | 75605-5143
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Country | US
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Telephone | 903-501-5056
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Fax | 903-499-5056
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Provider Business Mailing Address
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Address Line | 3204 4TH ST
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City | LONGVIEW
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State | TX
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Zip | 75605-5143
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Country | US
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Telephone | 903-501-5056
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Fax | 903-499-5056
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Authorized Official
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Title or Position | MANAGER
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Name | DR. BENJAMIN JACOB CAMERON
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Credential | DO
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Telephone | 903-501-5056
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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