Healthcare Provider Details

I. General information

NPI: 1275270852
Provider Name (Legal Business Name): ANTHONY CAMPBELL
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/16/2022
Last Update Date: 03/11/2025
Certification Date: 03/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

321 N MALL DR VW-103, ST. GEORGE, UTAH 84790
ST GEORGE UT
84770-2951
US

IV. Provider business mailing address

321 N MALL DR VW-103, ST. GEORGE, UTAH 84790
ST GEORGE UT
84770-2951
US

V. Phone/Fax

Practice location:
  • Phone: 435-767-1532
  • Fax:
Mailing address:
  • Phone: 435-767-1532
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: