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General NPI Number Information
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NPI Number | 1992052948
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Entity Type | Organization
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Legal Business Name | J JEFFERY CAMERON MD
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Dates
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Enumeration Date | 08/09/2012
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Last Update Date | 08/09/2012
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Provider Practice Location Address
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Address Line | 13170 RAVENNA RD SUITE 116
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City | CHARDON
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State | OH
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Zip | 44024-7025
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Country | US
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Telephone | 440-285-0828
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Fax | 440-285-8023
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Provider Business Mailing Address
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Address Line | 13170 RAVENNA RD SUITE 116
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City | CHARDON
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State | OH
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Zip | 44024-7025
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Country | US
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Telephone | 440-285-0828
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Fax | 440-285-8023
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. J JEFFERY CAMERON
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Credential | M.D.
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Telephone | 440-285-0828
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 35.051544
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License Number State | OH
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