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JACOB DALE CAMPBELL D.O. NPI 1811301377


NPI Information

NPI: 1811301377
Provider Name: JACOB DALE CAMPBELL, D.O.
Classification: Surgery - 2086S0120X
Entity Type: Individual

Specialization: Pediatric Surgery

PECOS Registration: Yes

Address:
UCONN SCHOOL OF MEDICINE DEPT OF SURGERY
263 FARMINGTON AVE
FARMINGTON, CT
ZIP 06030
Phone: (860) 679-2147
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Jacob Dale Campbell, D.O. is a pediatric surgery surgery in Farmington, CT with 10 years of experience. The provider is a surgeon with expertise in the management of surgical conditions in premature and newborn infants, children and adolescents. Jacob Dale Campbell, D.O. NPI is 1811301377. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: NOVA SOUTHEASTERN COLLEGE OF OSTEO MEDICINE
Graduation Year:2014

The provider's business location address is:

UCONN SCHOOL OF MEDICINE DEPT OF SURGERY
263 FARMINGTON AVE
FARMINGTON, CT
ZIP 06030-955
Phone: (860) 679-2147
Fax: (860) 679-4624

The NPI 1811301377 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/12/2014 and was last updated on 11/20/2023.


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
1390200000XStudent in an Organized Health Care Education/Training ProgramNo
22086S0120XSurgeryPediatric Surgery75461CONNECTICUTYes

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.