Healthcare Provider Details

I. General information

NPI: 1336083773
Provider Name (Legal Business Name): HARTFORD CAMPBELL JR. L.AC.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/16/2026
Last Update Date: 04/16/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

308 WEST AVE
NORTH AUGUSTA SC
29841-3816
US

IV. Provider business mailing address

1229 MANNING AVE
COLUMBIA SC
29204-2367
US

V. Phone/Fax

Practice location:
  • Phone: 404-510-6362
  • Fax:
Mailing address:
  • Phone: 404-510-6362
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number462
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: