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NPI Code Detail

MEDICARE: JOSHUA MICHAEL CAMPBELL PA-C

MEDICARE: JOSHUA MICHAEL CAMPBELL PA-C
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
1363A00000XPhysician Assistant10000825AIN
22255A2300XAthletic Trainer36001249AIN

General Provider Information

NPI Number : 1639144546
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSHUA MICHAEL CAMPBELL PA-C
Provider Business Mailing Address
First Line : 3901 S 7TH ST
Second Line :
City : TERRE HAUTE
State : IN
Zip : 47802-5709
Country : US
Telephone Number : 812-237-1622
Fax Number :
Provider Business Practice Location Address
First Line : 1500 N RITTER AVE
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46219-3027
Country : US
Telephone Number : 317-355-5457
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/22/2006
Last Update Date : 06/25/2021

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Directions to “ JOSHUA MICHAEL CAMPBELL PA-C” Practice Location

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