Healthcare Provider Details

I. General information

NPI: 1669474946
Provider Name (Legal Business Name): SCOTT W CAMPBELL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2005
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5016 GILMER RD
LONGVIEW TX
75604-9666
US

IV. Provider business mailing address

PO BOX 6605
TYLER TX
75711-6605
US

V. Phone/Fax

Practice location:
  • Phone: 903-653-1823
  • Fax: 903-653-1822
Mailing address:
  • Phone: 903-653-6000
  • Fax: 903-592-3224

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberL7678
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberL7678
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: