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NPI Code Detail

MEDICARE: LEOPOLD G CAMPBELL MD

MEDICARE:   LEOPOLD G CAMPBELL  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
1207RA0401XAddiction Medicine (Internal Medicine) Physician0101255209VA
2207R00000XInternal Medicine Physician0101255209VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11383POTHERNCBCBS OF NC
28533938OTHERNCCIGNA
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1962451765
Entity Type Code : Individual
Provider Name (Legal Business Name) : LEOPOLD G CAMPBELL MD
Provider Business Mailing Address
First Line : 4730 SUSSEX CT APT G
Second Line :
City : ROANOKE
State : VA
Zip : 24018-2348
Country : US
Telephone Number : 704-591-2819
Fax Number :
Provider Business Practice Location Address
First Line : 4346 STARKEY RD STE 1
Second Line :
City : ROANOKE
State : VA
Zip : 24018-0605
Country : US
Telephone Number : 540-772-8043
Fax Number : 540-772-8242
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/09/2006
Last Update Date : 11/17/2020

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Directions to “ LEOPOLD G CAMPBELL MD” Practice Location

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