Doctor Name: | DR. LUIS ISMAEL CAMPOS |
NPI Number: | 1366425027 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | MD038866L |
Business Practice Address: | 101 S 17th St Allentown, PA - 181046704 |
Business Phone Number: | 6108219228 |
Business Fax Number: | |
Mailing Address: | 101 S 17th St, ALLENTOWN |
State: | PA |
Postal Code: | 181046704 |
Phone Number: | 6108219228 |
Fax Number: | |
NPI Enumeration Date: | 11/26/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | MD038866L |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |