Healthcare Provider Details

I. General information

NPI: 1952398869
Provider Name (Legal Business Name): BARBARA A CAMPBELL D.P.M.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/05/2005
Last Update Date: 09/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10575 N TATUM BLVD STE C123
PARADISE VALLEY AZ
85253-1070
US

IV. Provider business mailing address

10575 N TATUM BLVD STE C123
PARADISE VALLEY AZ
85253-1070
US

V. Phone/Fax

Practice location:
  • Phone: 480-596-1008
  • Fax: 480-596-1191
Mailing address:
  • Phone: 480-596-1008
  • Fax: 480-596-1191

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number292
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code213EP1101X
TaxonomyPrimary Podiatric Medicine Podiatrist
License Number0292
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number0292
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: