MEDICARE: RODGER S CAMPBELL MD

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	208M00000X	Hospitalist Physician	105976	MO
2	207P00000X	Emergency Medicine Physician	105976	MO

General Provider Information

NPI Number	:	1336192582
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RODGER S CAMPBELL MD

Provider Business Mailing Address
First Line	:	106 WEST BLAIR DRIVE
Second Line	:
City	:	STOCKTON
State	:	MO
Zip	:	65785
Country	:	US
Telephone Number	:	417-276-5620
Fax Number	:

Provider Business Practice Location Address
First Line	:	106 WEST BLAIR DRIVE
Second Line	:
City	:	STOCKTON
State	:	MO
Zip	:	65785
Country	:	US
Telephone Number	:	417-276-5620
Fax Number	:

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

Provider Enumeration Date	:	05/18/2006
Last Update Date	:	02/16/2023

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