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General NPI Number Information
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NPI Number | 1114919347
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Entity Type | Individual
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Provider Name | WILLIAM B CAMPBELL DO
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Gender | Male
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Dates
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Enumeration Date | 08/15/2005
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Last Update Date | 03/17/2009
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Provider Practice Location Address
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Address Line | 105A RIDGECREST
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City | NIXA
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State | MO
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Zip | 65714-7807
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Country | US
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Telephone | 417-725-8250
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Fax | 417-725-8253
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Provider Business Mailing Address
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Address Line | 105A RIDGECREST
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City | NIXA
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State | MO
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Zip | 65714-7807
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Country | US
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Telephone | 417-725-8250
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Fax | 417-725-8253
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | R2D18
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License Number State | MO
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