Provider Demographics
NPI:1669709085
Name:JOSEPH F CAMPANA MD ASSOCIATES INC
Entity type:Organization
Organization Name:JOSEPH F CAMPANA MD ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR/PRES
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:F
Authorized Official - Last Name:CAMPANA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:570-323-7187
Mailing Address - Street 1:151 E 3RD ST
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSPORT
Mailing Address - State:PA
Mailing Address - Zip Code:17701-6622
Mailing Address - Country:US
Mailing Address - Phone:570-323-7187
Mailing Address - Fax:570-323-2189
Practice Address - Street 1:151 E 3RD ST
Practice Address - Street 2:
Practice Address - City:WILLIAMSPORT
Practice Address - State:PA
Practice Address - Zip Code:17701-6622
Practice Address - Country:US
Practice Address - Phone:570-323-7187
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-05
Last Update Date:2009-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA207W00000X302F00000X
PA207Y00000X302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0005931050001Medicaid
PAJ01623981OtherPRIVATE INSURANCE
PA021145119OtherPRIVATE INSURANCE
PA072713OtherPRIVATE INSURANCE
PAJ01623981OtherPRIVATE INSURANCE