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General NPI Number Information
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NPI Number | 1851305734
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Entity Type | Individual
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Provider Name | MELISSA M CAMPBELL M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/28/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 4802 E RAY RD STE 23-413
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City | PHOENIX
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State | AZ
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Zip | 85044-6405
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Country | US
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Telephone | 602-316-1752
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Fax |
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Provider Business Mailing Address
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Address Line | 4802 E RAY RD STE 23-413
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City | PHOENIX
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State | AZ
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Zip | 85044-6405
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Country | US
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Telephone | 602-316-1752
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 26530
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 5611
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License Number State | AK
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 0101049360
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License Number State | VA
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