Provider Demographics
NPI:1477973311
Name:CAMPODONICO, JOANNA JUDITH (MD, MPH)
Entity Type:Individual
Prefix:
First Name:JOANNA
Middle Name:JUDITH
Last Name:CAMPODONICO
Suffix:
Gender:F
Credentials:MD, MPH
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Mailing Address - Street 1:250 N SHADELAND AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46219-4959
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3000 S STATE ROAD 135 STE 200
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46143-9829
Practice Address - Country:US
Practice Address - Phone:317-535-1876
Practice Address - Fax:317-535-5049
Is Sole Proprietor?:No
Enumeration Date:2014-04-18
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ55132207Q00000X
IN01081950A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine