Provider Demographics
NPI:1225080740
Name:CAMPAGNONE, ROBERT PIERCE (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:PIERCE
Last Name:CAMPAGNONE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1185 MAIN ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:WILLIMANTIC
Mailing Address - State:CT
Mailing Address - Zip Code:06226-2093
Mailing Address - Country:US
Mailing Address - Phone:860-423-7558
Mailing Address - Fax:
Practice Address - Street 1:1185 MAIN ST
Practice Address - Street 2:SUITE 2
Practice Address - City:WILLIMANTIC
Practice Address - State:CT
Practice Address - Zip Code:06226-2093
Practice Address - Country:US
Practice Address - Phone:860-423-7558
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2007-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT033840207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTF85730Medicare UPIN