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General NPI Number Information
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NPI Number | 1700924743
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Entity Type | Individual
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Provider Name | MICHAEL LOUIS CAMPBELL M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/02/2007
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Last Update Date | 01/25/2022
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Provider Practice Location Address
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Address Line | 1325 ANDREA ST STE 201
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City | BOWLING GREEN
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State | KY
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Zip | 42104-5854
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Country | US
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Telephone | 270-843-7557
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Fax |
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Provider Business Mailing Address
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Address Line | 1325 ANDREA ST STE 201
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City | BOWLING GREEN
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State | KY
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Zip | 42104-5854
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Country | US
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Telephone | 270-843-7557
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Fax | 270-393-9664
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 41068
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License Number State | KY
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