Provider Demographics
NPI:1225019516
Name:CAMP, LINDA A (MD)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:A
Last Name:CAMP
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2094 E STATE ST STE G
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OH
Mailing Address - Zip Code:44460-4409
Mailing Address - Country:US
Mailing Address - Phone:330-332-1021
Mailing Address - Fax:
Practice Address - Street 1:2094 E STATE ST STE G
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OH
Practice Address - Zip Code:44460-4409
Practice Address - Country:US
Practice Address - Phone:330-332-7383
Practice Address - Fax:330-337-9298
Is Sole Proprietor?:No
Enumeration Date:2005-11-14
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL370663567174400000X
IN01071425A2086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2171475Medicaid
IL36119449Medicaid
IN201080210OtherMEDICAID
IL1326268202OtherGROUP NPI
INP01120501OtherRAILROAD MEDICARE
INP01120501OtherRAILROAD MEDICARE