Individual
DR. JOHN CAMPOBASSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
4716 NE VIVION RD, KANSAS CITY, MO 64119-2932
(816) 453-1314
(816) 453-3434
Mailing address
9411 N OAK TRFY, SUITE LL1, KANSAS CITY, MO 64155-2262
(816) 436-7072
(816) 436-2743
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
32861
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04364058
BCBS OF KC INDIVIDUAL #
—
Enumeration date
01/30/2006
Last updated
10/23/2007
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