| Provider / Organization | NPI | Date Certified |
|---|---|---|
| STACIE LEIGH CAMPO | 1417111576 | 2023-11-10 |
Stacie L Campo [F] graduated in 2011 and primarily specializes in General Surgery.
Stacie Leigh Campo is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1417111576. Registration indicates Stacie Leigh Campo is a provider of services with a specialization in Allopathic & Osteopathic Physicians, Surgery (Surgery, ) (Specialist Network, ) (Surgery, Allopathic & Osteopathic Physicians)
| PECOS ID | 4082886338 |
| Registration | PART-B:Y DME:Y HHA:Y PMD:Y |
| Entity Type | Individual |
| Provider Name | Dr. Stacie Leigh Campo MD |
| Practice Office Address | 2819 GREAT NORTHERN LOOP STE 200 MISSOULA, MT US |
| Practice Office Telephone | 4065427525 |
| Practice Office Fax | 4068290661 |
| Mailing Address | PO BOX 7817 MISSOULA SURGICAL ASSOCIATES MISSOULA, MT 59807 US |
| Business Telephone | 4065427525 |
| Business Fax | 4068290661 |
| Address | City / State | Phone / Fax |
|---|---|---|
| 6 13th Ave E | Polson, MT 598605315 | 4068835680 / 4068838910 |
| Direct Messaging Address [] | [email protected] | Direct |
| Code | Practice | License No State |
|---|---|---|
| 208600000X PRIMARY | Allopathic & Osteopathic Physicians Surgery Surgery Specialist Network Surgery Allopathic & Osteopathic Physicians | 12755
MT |
| 1417111576 | MEDICAID | MT |