Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | 28726 | CO |
NPI | 1043219066 |
---|---|
Provider Name | Dr. Douglas Martin Campbell |
First Address | Lakewood, CO 80214-5225 |
Second Address | Lakewood, CO 80214-5225 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2005 |
Last Update Date | 06/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01287267 | (05) | CO |
180007125 | RR MEDICARE (01) | CO |
815434 | AETNA HMO (01) | CO |
AMISR5601 | HMO CO (01) | CT |
CA02292 | BC/BS (01) | CO |
D74184 | (02) | CO |