Provider Demographics
NPI:1558362541
Name:LANSDOWNE ANESTHESIA AND PAIN MANAGEMENT, PC
Entity Type:Organization
Organization Name:LANSDOWNE ANESTHESIA AND PAIN MANAGEMENT, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:MARTIN
Authorized Official - Last Name:CAMPBELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-237-4561
Mailing Address - Street 1:PO BOX 775
Mailing Address - Street 2:
Mailing Address - City:BLUE BELL
Mailing Address - State:PA
Mailing Address - Zip Code:19422-0775
Mailing Address - Country:US
Mailing Address - Phone:610-237-4561
Mailing Address - Fax:
Practice Address - Street 1:1503 LANSDOWNE AVE STE 3006
Practice Address - Street 2:
Practice Address - City:DARBY
Practice Address - State:PA
Practice Address - Zip Code:19023-1306
Practice Address - Country:US
Practice Address - Phone:610-237-4561
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-02
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC0042Medicare PIN
080826Medicare PIN