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Individual

MR. JUAN CAMPOS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
110 S ANNISTON AVE, SYLACAUGA, AL 35150-2961
(256) 207-0200
(256) 207-0201
Mailing address
110 S ANNISTON AVE, STE. 110, SYLACAUGA, AL 35150-2961
(256) 401-4070
(256) 401-4603

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
00021307
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
051523150
AL
Enumeration date
10/04/2006
Last updated
10/17/2013
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