Provider Demographics
NPI:1467623660
Name:THOMAS W CAMPION
Entity Type:Organization
Organization Name:THOMAS W CAMPION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:W
Authorized Official - Last Name:CAMPION
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:908-850-9548
Mailing Address - Street 1:108 BILBY RD
Mailing Address - Street 2:SUITE 303
Mailing Address - City:HACKETTSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07840-4174
Mailing Address - Country:US
Mailing Address - Phone:908-850-9548
Mailing Address - Fax:908-813-3256
Practice Address - Street 1:108 BILBY RD
Practice Address - Street 2:SUITE 303
Practice Address - City:HACKETTSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07840-4174
Practice Address - Country:US
Practice Address - Phone:908-850-9548
Practice Address - Fax:908-813-3256
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-14
Last Update Date:2012-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA39788NJ174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJC56403Medicare UPIN
NJCA476658Medicare PIN