Provider Demographics
NPI:1881680635
Name:CAMPANA, ANTHONY F (OD)
Entity Type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:F
Last Name:CAMPANA
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:435 RIVER AVE
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSPORT
Mailing Address - State:PA
Mailing Address - Zip Code:17701-3722
Mailing Address - Country:US
Mailing Address - Phone:866-995-3937
Mailing Address - Fax:570-966-5586
Practice Address - Street 1:435 RIVER AVE
Practice Address - Street 2:
Practice Address - City:WILLIAMSPORT
Practice Address - State:PA
Practice Address - Zip Code:17701-3722
Practice Address - Country:US
Practice Address - Phone:866-995-3937
Practice Address - Fax:570-966-5586
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-26
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000364152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
00258OtherBCBS
072361OtherFPH
000258PFYMedicare PIN
00258OtherBCBS
043046Medicare ID - Type Unspecified