MEDICARE: DR. BRIAN CAMPBELL M.D.

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	207P00000X	Emergency Medicine Physician	35.071179	OH

General Provider Information

NPI Number	:	1699769984
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRIAN CAMPBELL M.D.

Provider Business Mailing Address
First Line	:	3110 PEPPER PIKE
Second Line	:
City	:	FINDLAY
State	:	OH
Zip	:	45840-2967
Country	:	US
Telephone Number	:	419-422-3769
Fax Number	:

Provider Business Practice Location Address
First Line	:	1250 S WASHINGTON ST
Second Line	:
City	:	VAN WERT
State	:	OH
Zip	:	45891-2551
Country	:	US
Telephone Number	:	419-238-8659
Fax Number	:

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

Provider Enumeration Date	:	09/01/2005
Last Update Date	:	07/08/2007

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