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NPI Code Detail

MEDICARE: TONY LEE CAMPBELL PA-C

MEDICARE: TONY LEE CAMPBELL PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant50.001445OH

General Provider Information

NPI Number : 1073741393
Entity Type Code : Individual
Provider Name (Legal Business Name) : TONY LEE CAMPBELL PA-C
Provider Business Mailing Address
First Line : 2339 CLEVELAND AVENUE
Second Line :
City : COLUMBUS
State : OH
Zip : 43211
Country : US
Telephone Number : 614-268-8221
Fax Number : 614-263-1891
Provider Business Practice Location Address
First Line : 2339 CLEVELAND AVE
Second Line :
City : COLUMBUS
State : OH
Zip : 43211-1609
Country : US
Telephone Number : 614-268-8221
Fax Number : 614-263-1891
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/25/2009
Last Update Date : 06/25/2009

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