MEDICARE: AARON MATTHEW CAMPBELL MS, CCC-A

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	231H00000X	Audiologist	207	OK

General Provider Information

NPI Number	:	1922259209
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AARON MATTHEW CAMPBELL MS, CCC-A

Provider Business Mailing Address
First Line	:	1901 ARLINGTON ST
Second Line	:
City	:	ADA
State	:	OK
Zip	:	74820-2816
Country	:	US
Telephone Number	:	405-732-0600
Fax Number	:

Provider Business Practice Location Address
First Line	:	1901 ARLINGTON ST
Second Line	:
City	:	ADA
State	:	OK
Zip	:	74820-2816
Country	:	US
Telephone Number	:	405-732-0600
Fax Number	:

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

Provider Enumeration Date	:	10/06/2008
Last Update Date	:	10/06/2008

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