Healthcare Provider Details

I. General information

NPI: 1265492011
Provider Name (Legal Business Name): GARY E CAMPBELL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2006
Last Update Date: 02/23/2026
Certification Date: 02/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1535 MEDICAL PKWY STE A
CARSON CITY NV
89703-4637
US

IV. Provider business mailing address

PO BOX 511647
LOS ANGELES CA
90051-8202
US

V. Phone/Fax

Practice location:
  • Phone: 775-883-5505
  • Fax: 775-883-6779
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number5477
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: