Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 12285 | AL |
NPI | 1134175367 |
---|---|
Provider Name | Virginia A Campbell |
First Address | Birmingham, AL 35242-7838 |
Second Address | Birmingham, AL 35233-1927 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/05/2006 |
Last Update Date | 06/08/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000051177 | (05) | AL |
051555572 | (05) | AL |
51555572 | BLUE CROSS (01) | AL |
C72065 | (02) | AL |
P00126467 | RRMCR (01) | AL |