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General NPI Number Information
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NPI Number | 1578907754
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Entity Type | Individual
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Provider Name | RYAN R. CAMPBELL MD
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Gender | Male
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Dates
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Enumeration Date | 04/18/2013
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Last Update Date | 08/01/2025
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Provider Practice Location Address
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Address Line | 1501 KINGS HWY DEPT. OF EMS
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City | SHREVEPORT
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State | LA
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Zip | 71103
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Country | US
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Telephone | 318-675-6632
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Fax |
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Provider Business Mailing Address
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Address Line | 1501 KINGS HWY DEPT. OF EMS
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City | SHREVEPORT
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State | LA
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Zip | 71103-4228
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Country | US
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Telephone | 318-675-6632
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Fax |
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 302035
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | S6583
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | S6583
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 302035
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License Number State | LA
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Taxonomy #5
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | M-17815
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License Number State | ID
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