MEDICARE: DOYLE RAY CAMPBELL MD

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
1	207R00000X	Internal Medicine Physician	ME19220	FL

General Provider Information

NPI Number	:	1548351463
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DOYLE RAY CAMPBELL MD

Provider Business Mailing Address
First Line	:	201 NW 70TH AVE
Second Line	:	SUITE D
City	:	PLANTATION
State	:	FL
Zip	:	33317-2369
Country	:	US
Telephone Number	:	954-693-9133
Fax Number	:	954-641-1451

Provider Business Practice Location Address
First Line	:	201 NW 70TH AVE
Second Line	:	SUITE D
City	:	PLANTATION
State	:	FL
Zip	:	33317-2369
Country	:	US
Telephone Number	:	954-693-9133
Fax Number	:	954-641-1451

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/27/2006
Last Update Date	:	11/20/2007

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