MEDICARE: JAKAYLA CAMPBELL ATC

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	2081S0010X	Sports Medicine (Physical Medicine & Rehabilitation) Physician	AT003670	GA

General Provider Information

NPI Number	:	1578194445
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAKAYLA CAMPBELL ATC

Provider Business Mailing Address
First Line	:	3096 SPRING HILL PKWY SE APT F
Second Line	:
City	:	SMYRNA
State	:	GA
Zip	:	30080-4752
Country	:	US
Telephone Number	:	843-532-1531
Fax Number	:

Provider Business Practice Location Address
First Line	:	3096 SPRING HILL PKWY SE APT F
Second Line	:
City	:	SMYRNA
State	:	GA
Zip	:	30080-4752
Country	:	US
Telephone Number	:	843-532-1531
Fax Number	:

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

Provider Enumeration Date	:	01/30/2020
Last Update Date	:	05/11/2026

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Directions to “ JAKAYLA CAMPBELL ATC” Practice Location

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