Provider Demographics
NPI:1356907638
Name:MAXON, CAMERON (DO)
Entity type:Individual
Prefix:DR
First Name:CAMERON
Middle Name:
Last Name:MAXON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HQ CO CARL R DARNALL AMC
Mailing Address - Street 2:BLDG 36050 S 58TH ST, FT CAVAZOS
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76544
Mailing Address - Country:US
Mailing Address - Phone:210-916-8666
Mailing Address - Fax:
Practice Address - Street 1:HQ CO CARL R DARNALL AMC
Practice Address - Street 2:BLDG 36050 S 58TH ST, FT CAVAZOS
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76544
Practice Address - Country:US
Practice Address - Phone:210-916-8666
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-13
Last Update Date:2023-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2287207L00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology