Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | A130780 | CA |
N | 207X00000X | Orthopaedic Surgeon | D83628 | MD |
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | MD047881 | DC |
NPI | 1437564150 |
---|---|
Provider Name | Joshua Clark Campbell |
First Address | Washington, DC 20037-1597 |
Second Address | Washington, DC 20037 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2014 |
Last Update Date | 30/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A130780 | CALIFORNIA MEDICAL LICENSE (01) | CA |
D83628 | MARYLAND MEDICAL LICENSE (01) | MD |
MD047881 | DC MEDICAL LICENSE (01) | DC |