Healthcare Provider Details

I. General information

NPI: 1144376997
Provider Name (Legal Business Name): CAMPBELL DERMATOLOGY PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

784 CENTRAL AVE
DOVER NH
03820-3412
US

IV. Provider business mailing address

784 CENTRAL AVE
DOVER NH
03820-3412
US

V. Phone/Fax

Practice location:
  • Phone: 603-742-5556
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JAMES L CAMPBELL JR.
Title or Position: OWNER
Credential: MD
Phone: 603-742-5556