Healthcare Provider Details

I. General information

NPI: 1083692974
Provider Name (Legal Business Name): WILLIAM DAVID CAMPBELL D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: WILLIAM DAVID CAMPBELL DPM

II. Dates (important events)

Enumeration Date: 01/03/2006
Last Update Date: 05/29/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 INDEPENDENCE PLZ STE 530
BIRMINGHAM AL
35209-2646
US

IV. Provider business mailing address

1 INDEPENDENCE PLZ STE 530
BIRMINGHAM AL
35209-2646
US

V. Phone/Fax

Practice location:
  • Phone: 205-445-0661
  • Fax: 205-445-0664
Mailing address:
  • Phone: 205-445-0661
  • Fax: 205-445-0664

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberPO1928
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number322
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: