MEDICARE: DR. WILLIAM S. CAMPBELL JR. 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	2085R0202X	Diagnostic Radiology Physician	R1J43	MO
2	2085R0204X	Vascular & Interventional Radiology Physician	ME51689	FL
3	2085R0202X	Diagnostic Radiology Physician	ME51689	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	063896	OTHER		HEALTH ALLIANCE
2	430954380CAP	OTHER		MERCY HEALTH PLAN
3	95529	OTHER	FL	BCBS
4	036-068623	OTHER	IL	IL BLUE CROSS BLUE SHIELD
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	185214	OTHER	MO	MO BLUE CROSS BLUE SHIELD
9	254725	OTHER		HEALTHLINK
10	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1609882968
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM S. CAMPBELL JR. MD

Provider Business Mailing Address
First Line	:	609 N BAY DR
Second Line	:
City	:	LYNN HAVEN
State	:	FL
Zip	:	32444-3026
Country	:	US
Telephone Number	:	503-813-8478
Fax Number	:

Provider Business Practice Location Address
First Line	:	609 N BAY DR
Second Line	:
City	:	LYNN HAVEN
State	:	FL
Zip	:	32444-3026
Country	:	US
Telephone Number	:	503-813-8478
Fax Number	:

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

Provider Enumeration Date	:	07/31/2006
Last Update Date	:	06/23/2025

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