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NPI Code Detail

MEDICARE: JOHN CAMPBELL M.D.

MEDICARE: JOHN CAMPBELL M.D.
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
12085R0202XDiagnostic Radiology PhysicianK6754TX

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
7P00048098OTHERTXTRAVELER MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1752961826A008OTHERTXCHAMPUS
2157336201OTHERTXCOUNTY AGENCY
3120535OTHERTXCHIP PROGRAM
4MDK6754OTHERTXWORKERS COMP
5MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
68H0680OTHERTXBLUE CROSS BLUE SHIELD TX

General Provider Information

NPI Number : 1689631285
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN CAMPBELL M.D.
Provider Business Mailing Address
First Line : 1701 OAKMONT CIR
Second Line :
City : LONGVIEW
State : TX
Zip : 75605-2660
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2001 N JEFFERSON AVE
Second Line :
City : MOUNT PLEASANT
State : TX
Zip : 75455-2338
Country : US
Telephone Number : 903-577-6000
Fax Number : 903-577-6245
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/27/2006
Last Update Date : 11/11/2025

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