Provider Demographics
NPI:1124041116
Name:CAMPBELL, RONALD BRET (DO)
Entity Type:Individual
Prefix:MR
First Name:RONALD
Middle Name:BRET
Last Name:CAMPBELL
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:1404 POMERELLE AVE
Mailing Address - Street 2:STE B
Mailing Address - City:BURLEY
Mailing Address - State:ID
Mailing Address - Zip Code:83318-2013
Mailing Address - Country:US
Mailing Address - Phone:208-878-9434
Mailing Address - Fax:208-878-4576
Practice Address - Street 1:1501 HILAND AVE
Practice Address - Street 2:SUITE A
Practice Address - City:BURLEY
Practice Address - State:ID
Practice Address - Zip Code:83318-2682
Practice Address - Country:US
Practice Address - Phone:208-878-9432
Practice Address - Fax:208-878-4576
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2017-02-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IDO-338207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine