MEDICARE: MR. ANTHONY F. CAMPANA 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
1	152W00000X	Optometrist	OEG000364	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	00258	OTHER		BCBS
2	072361	OTHER		FPH

General Provider Information

NPI Number	:	1881680635
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ANTHONY F. CAMPANA OD

Provider Business Mailing Address
First Line	:	435 RIVER AVE
Second Line	:
City	:	WILLIAMSPORT
State	:	PA
Zip	:	17701-3722
Country	:	US
Telephone Number	:	866-995-3937
Fax Number	:	570-966-5586

Provider Business Practice Location Address
First Line	:	435 RIVER AVE
Second Line	:
City	:	WILLIAMSPORT
State	:	PA
Zip	:	17701-3722
Country	:	US
Telephone Number	:	866-995-3937
Fax Number	:	570-966-5586

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

Provider Enumeration Date	:	09/26/2005
Last Update Date	:	03/08/2024

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