C. E. Campbell, Jr MD PA

Primary specialty

SpecialistTaxonomy code 174400000X

License

R1755 Issued in AR

Legal business name

C. E. CAMPBELL, JR MD PA

Practice address

609 Fulton St
Blytheville, AR 72315-1922

Phone

(870) 763-0855

Fax

(870) 763-0858

NPI assigned

Aug 5, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Lynda White

Title

Billing Administrator

Phone

(870) 763-0855

Specialties & licenses 1

Addresses

Other identifiers 5

Locations

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• C. E. Campbell Jr., M.D., PA

  • Specialist
  • Blytheville, AR
  • NPI 1114934353
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1186272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1298937600000",
    "number": "1104017227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "609 FULTON ST",
            "city": "BLYTHEVILLE",
            "state": "AR",
            "postal_code": "723151922",
            "telephone_number": "870-763-0855",
            "fax_number": "870-763-0858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "609 FULTON ST",
            "city": "BLYTHEVILLE",
            "state": "AR",
            "postal_code": "723151922",
            "telephone_number": "870-763-0855",
            "fax_number": "870-763-0858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "C. E. CAMPBELL, JR MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-05",
        "last_updated": "2011-03-01",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "LYNDA",
        "authorized_official_title_or_position": "BILLING ADMINISTRATOR",
        "authorized_official_telephone_number": "870-763-0855"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "AR",
            "license": "R1755",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103491002",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "501821003",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID (GROUP)",
            "identifier": "103491002",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1114934353",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1104017227",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Claire Bryeans, LMSW
• Jamie Lynn Burgess, LPN
• Michelle Burks, APRN
• Frank E Button, OD
• Jennifer A Button, OD
• C. E. Campbell Jr., M.D., PA
• Annie Mae Cannon
• Careway Transportation LLC
• Caring Caravan, LLC
• Caring Caravan, LLC

• All providers in Blytheville, AR
• Specialist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.