Provider Demographics
NPI:1407126618
Name:CAMPANILE PLASTIC SURGERY, PLLC
Entity Type:Organization
Organization Name:CAMPANILE PLASTIC SURGERY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FRANCESCO
Authorized Official - Middle Name:E
Authorized Official - Last Name:CAMPANILE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-345-7476
Mailing Address - Street 1:425 S CHERRY ST
Mailing Address - Street 2:SUITE 321
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80246-1226
Mailing Address - Country:US
Mailing Address - Phone:303-345-7476
Mailing Address - Fax:
Practice Address - Street 1:425 S CHERRY ST
Practice Address - Street 2:SUITE 321
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80246-1226
Practice Address - Country:US
Practice Address - Phone:303-345-7476
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-04
Last Update Date:2012-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NEG39827Medicare UPIN