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NPI Code Detail

MEDICARE: MR. DWIGHT ADONIS CAMPBELL SR. CFSA

MEDICARE:  MR. DWIGHT ADONIS CAMPBELL SR. CFSA
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
1246ZC0007XSurgical AssistantSA.0001002CO

General Provider Information

NPI Number : 1437271574
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. DWIGHT ADONIS CAMPBELL SR. CFSA
Provider Business Mailing Address
First Line : 12272 JASPER ST
Second Line :
City : COMMERCE CITY
State : CO
Zip : 80603-7006
Country : US
Telephone Number : 720-939-4670
Fax Number :
Provider Business Practice Location Address
First Line : 12272 JASPER ST
Second Line :
City : COMMERCE CITY
State : CO
Zip : 80603-7006
Country : US
Telephone Number : 720-939-4670
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/06/2007
Last Update Date : 06/28/2019

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Directions to “ MR. DWIGHT ADONIS CAMPBELL SR. CFSA” Practice Location

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