Healthcare Provider Details

I. General information

NPI: 1194406942
Provider Name (Legal Business Name): JOHN GIVEN CAMPBELL PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/25/2023
Last Update Date: 02/25/2026
Certification Date: 02/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8352 W WARM SPRINGS RD STE 300A
LAS VEGAS NV
89113-3631
US

IV. Provider business mailing address

5122 ELK RIVER RD N
ELKVIEW WV
25071-9722
US

V. Phone/Fax

Practice location:
  • Phone: 702-851-7287
  • Fax: 702-851-7286
Mailing address:
  • Phone: 304-550-2126
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA3281
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: