Healthcare Provider Details

I. General information

NPI: 1619897691
Provider Name (Legal Business Name): STUART CAMPBELL
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7300 MAYO ST NW
ALBUQUERQUE NM
87120-3571
US

IV. Provider business mailing address

7300 MAYO ST NW
ALBUQUERQUE NM
87120-3571
US

V. Phone/Fax

Practice location:
  • Phone: 505-730-6245
  • Fax:
Mailing address:
  • Phone: 505-730-6245
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code146L00000X
TaxonomyParamedic
License Number08000656
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code246XC2901X
TaxonomyCardiovascular Invasive Specialist/Technologist
License NumberM8061189
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: