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NPI Code Detail

MEDICARE: JENNIFER D CAMPBELL M.D., F.A.C.O.G.

MEDICARE: JENNIFER D CAMPBELL M.D., F.A.C.O.G.
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
1207V00000XObstetrics & Gynecology PhysicianK9744TX

General Provider Information

NPI Number : 1689675969
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER D CAMPBELL M.D., F.A.C.O.G.
Provider Business Mailing Address
First Line : 7777 FOREST LN
Second Line : C-234
City : DALLAS
State : TX
Zip : 75230-2505
Country : US
Telephone Number : 972-566-7711
Fax Number :
Provider Business Practice Location Address
First Line : 6124 W PARKER RD
Second Line : BLDG 3, SUITE 136
City : PLANO
State : TX
Zip : 75093-8122
Country : US
Telephone Number : 972-981-7711
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/09/2005
Last Update Date : 10/23/2007

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