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General NPI Number Information
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NPI Number | 1689037186
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Entity Type | Individual
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Provider Name | CHRISTOPHER MARK CAMPBELL M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/01/2016
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Last Update Date | 08/04/2021
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Provider Practice Location Address
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Address Line | 2710 S RIFE MEDICAL LN
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City | ROGERS
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State | AR
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Zip | 72758-1452
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Country | US
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Telephone | 913-707-7408
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Fax |
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Provider Business Mailing Address
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Address Line | 406 BIRKSHIRE RD
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City | CAVE SPRINGS
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State | AR
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Zip | 72718-4014
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Country | US
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Telephone | 913-707-7408
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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 | 208800000X
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Taxonomy Name | Urology Physician
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License Number | E-14241
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License Number State | AR
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