Provider Demographics
NPI:1295464410
Name:CAMP, RILEY WILLIAM (OD)
Entity Type:Individual
Prefix:DR
First Name:RILEY
Middle Name:WILLIAM
Last Name:CAMP
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Mailing Address - Street 1:110 COLLEGE ST STE B
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:AL
Mailing Address - Zip Code:35611-2714
Mailing Address - Country:US
Mailing Address - Phone:256-587-2139
Mailing Address - Fax:256-233-2309
Practice Address - Street 1:110 COLLEGE ST STE B
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:AL
Practice Address - Zip Code:35611-2714
Practice Address - Country:US
Practice Address - Phone:256-587-2139
Practice Address - Fax:256-233-2309
Is Sole Proprietor?:No
Enumeration Date:2022-06-06
Last Update Date:2022-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALS-E95152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist