Provider Demographics
NPI:1861753709
Name:CAMP, NICHOLAS BENJAMIN (MD)
Entity type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:BENJAMIN
Last Name:CAMP
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2900 MEDICAL CENTER PKWY STE 110
Mailing Address - Street 2:
Mailing Address - City:BENTONVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72712-3212
Mailing Address - Country:US
Mailing Address - Phone:479-715-4262
Mailing Address - Fax:866-817-7601
Practice Address - Street 1:2900 MEDICAL CENTER PKWY STE 110
Practice Address - Street 2:
Practice Address - City:BENTONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72712-3212
Practice Address - Country:US
Practice Address - Phone:479-715-4262
Practice Address - Fax:866-817-7601
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-07
Last Update Date:2022-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2017004412207LP2900X
ARE-10371207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine