Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 01036153 | IN |
N | 207Q00000X | Family Doctor | 23424 | KY |
N | 207QA0401X | Family Doctor - Addiction Medicine | 23424 | KY |
NPI | 1518063585 |
---|---|
Provider Name | Dr. Jeffrey Alan Campbell |
First Address | Jeffersonville, IN 47130-6016 |
Second Address | Jeffersonville, IN 47130-6016 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/09/2006 |
Last Update Date | 04/03/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000050807 | ANTHEM (01) | IN |
004272 | SIHO (01) | IN |
080067815 | PALMETTO (01) | IN |
100464320 | (05) | IN |
1018897 | CHAMPUS (01) | IN |
1195507 | CHA HEALTH (01) | IN |
C68822 | (02) | IN |