Physician Compare National (NPI:1205939550)

HEALTHCARE PROVIDER: TREADWELL CAMPBELL M.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1205939550
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	3476450222
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20091026000033
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	CAMPBELL
	Individual professional last name
Provider First Name	TREADWELL
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	MEHARRY MEDICAL COLLEGE SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	1985
	Individual professional's medical school graduation year
Primary Specialty	FAMILY MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	EMERGENCY MEDICINE
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	EMERGENCY MEDICINE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	2835 E HWY 76
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 6
	Group Practice or individual's line 2 address
City	MULLINS
	Group Practice or individual's city
State	SC
	Group Practice or individual's state
Zip Code	295746038
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	420055
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	CAROLINAS HOSPITAL SYSTEM MARION
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y