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NPI Code Detail

MEDICARE: LORNE R CAMPBELL SR. MD

MEDICARE: LORNE R CAMPBELL SR. 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
1207Q00000XFamily Medicine Physician055562GA
2207Q00000XFamily Medicine Physician164798NY

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 : 1578568150
Entity Type Code : Individual
Provider Name (Legal Business Name) : LORNE R CAMPBELL SR. MD
Provider Business Mailing Address
First Line : 346 GRAND AVE
Second Line :
City : JOHNSON CITY
State : NY
Zip : 13790-2580
Country : US
Telephone Number : 607-763-6075
Fax Number : 607-763-5234
Provider Business Practice Location Address
First Line : 40 ARCH ST
Second Line :
City : JOHNSON CITY
State : NY
Zip : 13790-2102
Country : US
Telephone Number : 607-763-6075
Fax Number : 607-763-5234
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/20/2005
Last Update Date : 11/04/2014

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