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General NPI Number Information
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NPI Number | 1760352637
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Entity Type | Individual
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Provider Name | NOAH DWAYNE CAMPBELL JR.
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Gender | Male
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Dates
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Enumeration Date | 11/06/2025
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Last Update Date | 11/06/2025
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Provider Practice Location Address
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Address Line | 231 E CHOCCOLOCCO ST
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City | OXFORD
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State | AL
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Zip | 36203-1223
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Country | US
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Telephone | 256-342-6107
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Fax |
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Provider Business Mailing Address
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Address Line | 310 VALLEY ST APT D
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City | GADSDEN
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State | AL
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Zip | 35905-1753
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Country | US
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Telephone | 256-613-7302
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6546C
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License Number State | AL
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