Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 47337 | CO |
N | 207Q00000X | Family Doctor | 5230245-1205 | UT |
N | 207QS0010X | Family Doctor - Sports Medicine | 5230245-1205 | UT |
NPI | 1124007836 |
---|---|
Provider Name | Darren Campbell |
First Address | Usaf Academy, CO 80840-2502 |
Second Address | Usaf Academy, CO 80840-2502 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/01/2006 |
Last Update Date | 01/03/2017 |