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4303 Free Union Road Free Union VA 22940 | |
(434) 978-1691 | |
Not Available |
Full Name | |
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Speciality | Family Medicine |
Location | 4303 Free Union Road, Free Union, Virginia |
Authorized Official Name and Position | Bruce Donald Campbell (OWNER/PHYSICIAN) |
Authorized Official Contact | 4349781691 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 220 Free Union VA 22940-0220 Ph: (434) 978-1691 | 4303 Free Union Road Free Union VA 22940 Ph: (434) 978-1691 |
NPI Number | 1144362146 |
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Provider Enumeration Date | 02/13/2007 |
Last Update Date | 04/12/2023 |
Medicare PECOS PAC ID | 3072974260 |
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Medicare Enrollment ID | O20230803004336 |
Identifier | Type | State | Issuer |
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1144362146 | NPI | - | NPPES |
005624738 | Medicaid | VA |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | 0101035228 (Virginia) | Primary |
Provider Name | Bruce Donald Campbell |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1700922457 PECOS PAC ID: 1951577311 Enrollment ID: I20120106000006 |