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NPI Code Detail

MEDICARE: DR. JAMES THOMAS VANCAMP OD

MEDICARE:  DR. JAMES THOMAS VANCAMP  OD
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
1152W00000XOptometristOPT1190CO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1154441350
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JAMES THOMAS VANCAMP OD
Provider Business Mailing Address
First Line : PO BOX 1009
Second Line :
City : MONUMENT
State : CO
Zip : 80132-1009
Country : US
Telephone Number : 719-598-6000
Fax Number : 719-559-0136
Provider Business Practice Location Address
First Line : 1465 KELLY JOHNSON BLVD
Second Line : STE 110
City : COLORADO SPRINGS
State : CO
Zip : 80920-3955
Country : US
Telephone Number : 719-598-6000
Fax Number : 719-559-0136
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/30/2007
Last Update Date : 03/07/2023

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Directions to “ DR. JAMES THOMAS VANCAMP OD” Practice Location

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