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C. E. CAMPBELL JR MD PA NPI 1104017227


NPI Information

NPI: 1104017227
Provider Name: C. E. CAMPBELL, JR MD PA
Classification: Specialist - 174400000X
Entity Type: Organization
Address:
609 FULTON ST
BLYTHEVILLE, AR
ZIP 72315
Phone: (870) 763-0855
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C. E. CAMPBELL, JR MD PA is a specialist in Blytheville, AR. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. C. E. CAMPBELL, JR MD PA NPI is 1104017227. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

609 FULTON ST
BLYTHEVILLE, AR
ZIP 72315-922
Phone: (870) 763-0855
Fax: (870) 763-0858

The provider's authorized official is Lynda White .
The authorized official title is Billing Administrator and has the following contact phone number (870) 763-0855.

The enumeration date for this NPI number is 8/5/2007 and was last updated on 3/1/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1174400000XSpecialistR1755ARKANSASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1EO5469MEDICARE UPINARKANSAS
2103491002OTHERARKANSASMEDICAID (GROUP)
3103491002MEDICAIDARKANSAS
41114934353OTHERARKANSASINDIVIDUAL NPI
51104017227OTHERARKANSASGROUP NPI
6501821003MEDICAIDMISSOURI
757299MEDICARE PINARKANSAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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