Healthcare Provider Details

I. General information

NPI: 1679676605
Provider Name (Legal Business Name): PATRICK SCOTT CAMPBELL DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/06/2006
Last Update Date: 05/07/2025
Certification Date: 05/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5006 ATWOOD DR STE 5
RICHMOND KY
40475-8179
US

IV. Provider business mailing address

5006 ATWOOD DR STE 5
RICHMOND KY
40475-8179
US

V. Phone/Fax

Practice location:
  • Phone: 859-626-8833
  • Fax: 859-626-8832
Mailing address:
  • Phone: 859-626-8833
  • Fax: 859-626-8832

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number250119
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number4523
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: