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Individual

DR. DOLLY ANN CAMPBELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
O.D

Contact information

Practice address
1207 N ONE MILE RD, DEXTER, MO 63841-1041
(573) 624-4584
(573) 624-4585
Mailing address
1200 W DEYOUNG ST, MARION, IL 62959-4437
(618) 993-5686
(618) 997-6250

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
205031543
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0814870002
MEDICARE NSC NUMBER
MO
01
0814870006
MEDICARE NSC NUMBER
MO
01
0814870015
MEDICARE NSC NUMBER
MO
01
0814870017
MEDICARE NSC NUMBER
MO
01
137071
HEALTH ALLIANCE
01
220392
ANTHEM BLUE CROSS BLUE SHIELD
MO
05
317565307
MO
01
MO1543
EYEMED
01
P00418700 CI6575
MEDICARE RAILROAD
MO
Enumeration date
02/22/2006
Last updated
10/01/2008
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