Individual ProviderMiles CampbellInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address1100 Wilford Hall Loop, Bldg 4554, Jbsa Lackland, TX 78236(210) 292-7862PECOS EnrollmentBased on the most recent information from CMS, provider Miles Campbell is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1437770567Provider TypeIndividualFull NameCampbell, MilesCredentialDOGenderMaleSole ProprietorYesEnumeration Date4/29/2020Last Updated10/26/2023Contact InformationPractice LocationPractice Address1100 Wilford Hall Loop, Bldg 4554, Jbsa Lackland, TX 78236Phone(210) 292-7862FaxUnlisted FaxMailing LocationMailing Address1100 Wilford Hall Loop, Bldg 4554, Jbsa Lackland, TX 78236PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode207R00000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicenseOS19650FloridaCode207R00000XDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicenseLP05397Rhode Island