MEDICARE: DR. DENNIS ALAN CAMP D.PH.

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	183500000X	Pharmacist	7359	OK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	371377	OTHER	OK	CAREMARK
2	8731400001-500	OTHER	OK	BLUE CROSS & BLUE SHIELD

General Provider Information

NPI Number	:	1679651467
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DENNIS ALAN CAMP D.PH.

Provider Business Mailing Address
First Line	:	1 MEDICAL PLAZA
Second Line	:
City	:	RATLIFF CITY
State	:	OK
Zip	:	73481-0117
Country	:	US
Telephone Number	:	580-856-3333
Fax Number	:	580-856-3607

Provider Business Practice Location Address
First Line	:	1 MEDICAL PLAZA
Second Line	:
City	:	RATLIFF CITY
State	:	OK
Zip	:	73481-0117
Country	:	US
Telephone Number	:	580-856-3333
Fax Number	:	580-856-3607

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

Provider Enumeration Date	:	11/01/2006
Last Update Date	:	07/18/2007

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Directions to “ DR. DENNIS ALAN CAMP D.PH.” Practice Location

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