Organization
RALPH P CAMPANALE MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RALPH P CAMPANALE MD (OWNER)
(208) 726-3707
Entity
Organization
Contact information
Practice address
180 WEST 1ST ST, SUITE 301, KETCHUM, ID 83340
(208) 726-3707
(208) 726-4817
Mailing address
PO BOX 3778, KETCHUM, ID 83340-3778
(208) 726-3707
(208) 726-4817
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
M4961
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002699100
—
ID
Enumeration date
05/14/2008
Last updated
05/14/2008
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