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NPI Code Detail

MEDICARE: MR. ALAN DALE CAMPBELL

MEDICARE:  MR. ALAN DALE CAMPBELL
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
1376J00000XHomemaker

General Provider Information

NPI Number : 1952133175
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ALAN DALE CAMPBELL
Provider Business Mailing Address
First Line : 1909 PROVINCETOWN RD
Second Line :
City : WASHINGTON TOWNSHIP
State : OH
Zip : 45459-3439
Country : US
Telephone Number : 228-219-4312
Fax Number :
Provider Business Practice Location Address
First Line : 1909 PROVINCETOWN RD
Second Line :
City : WASHINGTON TOWNSHIP
State : OH
Zip : 45459-3439
Country : US
Telephone Number : 228-219-4312
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/16/2024
Last Update Date : 08/16/2024

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Directions to “ MR. ALAN DALE CAMPBELL ” Practice Location

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