Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 162371-1205 | UT |
NPI | 1023059557 |
---|---|
Provider Name | Dr. Curtis M Campbell |
First Address | Ogden, UT 84403-3271 |
Second Address | Ogden, UT 84403-3271 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
DO 7366 | (02) | UT |