| R Bret Campbell Do & Assoc Llc | |
|
1501 Hiland Ave Ste A Burley ID 83318-2688 | |
| (208) 878-9432 | |
| (208) 878-4576 |
| Full Name | R Bret Campbell Do & Assoc Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 1501 Hiland Ave Ste A, Burley, Idaho |
| Authorized Official Name and Position | R Bret Campbell (DOCTOR OF OSTEOPATHY) |
| Authorized Official Contact | 2088789432 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| R Bret Campbell Do & Assoc Llc 1404 Pomerelle Ave Suite B Burley ID 83318-2688 Ph: (208) 878-9432 | R Bret Campbell Do & Assoc Llc 1501 Hiland Ave Ste A Burley ID 83318-2688 Ph: (208) 878-9432 |
| NPI Number | 1952744641 |
|---|---|
| Provider Enumeration Date | 04/11/2013 |
| Last Update Date | 03/29/2016 |
| Medicare PECOS PAC ID | 2860799905 |
|---|---|
| Medicare Enrollment ID | O20160405000354 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952744641 | NPI | - | NPPES |
| 1124041116 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 363L00000X | Nurse Practitioner | (* (Not Available)) | Secondary |
| Provider Name | Ronald Bret Campbell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124041116 PECOS PAC ID: 7416937131 Enrollment ID: I20040826000418 |
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