Healthcare Provider Details

I. General information

NPI: 1104111731
Provider Name (Legal Business Name): SARAH F CAMPBELL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARAH ANN FORD

II. Dates (important events)

Enumeration Date: 06/11/2011
Last Update Date: 08/07/2024
Certification Date: 08/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

175 MADISON AVE FL 1
MOUNT HOLLY NJ
08060-2099
US

IV. Provider business mailing address

301 LIPPINCOTT DR STE 410
MARLTON NJ
08053-4197
US

V. Phone/Fax

Practice location:
  • Phone: 609-914-6000
  • Fax:
Mailing address:
  • Phone: 856-355-0340
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberTRN15925
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number25MA10599000
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberME124875
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: