Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | ||
N | 222Z00000X | Podiatrist | ||
Y | 224P00000X | Prosthetist |
NPI | 1295121796 |
---|---|
Provider Name | Nicholas Paul Campbell |
First Address | Gastonia, NC 28054-0628 |
Second Address | Gastonia, NC 28054-0628 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2015 |
Last Update Date | 24/02/2016 |