Healthcare Provider Details

I. General information

NPI: 1972814481
Provider Name (Legal Business Name): AARON CAMPBELL DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2010
Last Update Date: 12/16/2024
Certification Date: 12/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

830 WASHINGTON ST
WATERTOWN NY
13601-4034
US

IV. Provider business mailing address

830 WASHINGTON ST
WATERTOWN NY
13601-4034
US

V. Phone/Fax

Practice location:
  • Phone: 315-786-7300
  • Fax: 315-786-7310
Mailing address:
  • Phone: 315-779-5298
  • Fax: 315-779-5295

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number267004
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number267004
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: