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Organization

BLACK HILLS UROLOGY GROUP, P.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MICHAEL A CAMPENNI D.O. (CO.OWNER/PRESIDENT)
(928) 649-7970
Entity
Organization

Contact information

Practice address
294 W STATE ROUTE 89A, SUITE 208, COTTONWOOD, AZ 86326-3754
(928) 649-7970
(928) 649-7971
Mailing address
294 W STATE ROUTE 89A, SUITE 208, COTTONWOOD, AZ 86326-3754
(928) 649-7970
(928) 649-7971

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
36999
AZ
208800000X
Urology Physician
Primary
4639
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1801069158
GROUP NPI FOR BLACK HILLS UROLOGY
AZ
05
324852
AZ
05
328233
AZ
01
36999
FOR DR. STEVEN KURZWEIL
AZ
01
4639
FOR DR. MICHAEL CAMPENNI
AZ
Enumeration date
04/08/2008
Last updated
11/15/2012
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