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NPI Code Detail

MEDICARE: WILLIAM B CAMPBELL DO

MEDICARE: WILLIAM B CAMPBELL DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianR2D18MO

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P00174740OTHERRR MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1114919347
Entity Type Code : Individual
Provider Name (Legal Business Name) : WILLIAM B CAMPBELL DO
Provider Business Mailing Address
First Line : 105A RIDGECREST
Second Line :
City : NIXA
State : MO
Zip : 65714-7807
Country : US
Telephone Number : 417-725-8250
Fax Number : 417-725-8253
Provider Business Practice Location Address
First Line : 105A RIDGECREST
Second Line :
City : NIXA
State : MO
Zip : 65714-7807
Country : US
Telephone Number : 417-725-8250
Fax Number : 417-725-8253
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/15/2005
Last Update Date : 03/17/2009

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