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NPI Code Detail

MEDICARE: DR. JAMES R CAMPBELL D.O.

MEDICARE: DR. JAMES R CAMPBELL D.O.
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
1207Q00000XFamily Medicine Physician1880OK

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1731328479OTHEROKTAX IDENTIFICATION NUMBER
21880OTHEROKSTATE LICENSE NUMBER

General Provider Information

NPI Number : 1720091077
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JAMES R CAMPBELL D.O.
Provider Business Mailing Address
First Line : 510 N ELM PL
Second Line :
City : BROKEN ARROW
State : OK
Zip : 74012-2539
Country : US
Telephone Number : 918-251-1391
Fax Number : 918-251-3008
Provider Business Practice Location Address
First Line : 510 N ELM PL
Second Line :
City : BROKEN ARROW
State : OK
Zip : 74012-2539
Country : US
Telephone Number : 918-251-1391
Fax Number : 918-251-3008
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/15/2006
Last Update Date : 02/05/2024

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Directions to “ DR. JAMES R CAMPBELL D.O.” Practice Location

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