MEDICARE: DR. JOSHUA A CAMPBELL DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	DS8796	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1104009646
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSHUA A CAMPBELL DDS

Provider Business Mailing Address
First Line	:	PO BOX 440301
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37244-0301
Country	:	US
Telephone Number	:	865-670-6199
Fax Number	:	865-670-6198

Provider Business Practice Location Address
First Line	:	11213 WEST POINT DR.
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37934-2838
Country	:	US
Telephone Number	:	865-675-0677
Fax Number	:	865-675-0681

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/06/2007
Last Update Date	:	12/05/2019

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