# RALPH P CAMPANALE MD PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114194586
- **Authorized official:** DR. RALPH P CAMPANALE MD (OWNER)
- **Authorized official phone:** (208) 726-3707

## Contact information

- **Practice address:** 180 WEST 1ST ST, SUITE 301, KETCHUM, ID 83340
- **Practice address phone:** (208) 726-3707
- **Practice address fax:** (208) 726-4817
- **Mailing address:** PO BOX 3778, KETCHUM, ID 83340-3778
- **Mailing address phone:** (208) 726-3707
- **Mailing address fax:** (208) 726-4817

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 174400000X | Specialist | M4961 | ID | Yes |

## Other

- **Enumeration date:** 05/14/2008
- **Last updated:** 05/14/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 002699100 | — | ID |