Charles Whitfield Campbell Jr., M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MA51936 Issued in NJ

Practice address

86 S Cobb Dr SE
Mail Drop 0454
Marietta, GA 30063-0454

Phone

(770) 494-5001

Fax

(770) 494-7490

NPI assigned

Jun 1, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Premise Health of Georgia Medical, P.C.

  • Multi-Specialty Clinic/Center
  • Marietta, GA
  • NPI 1013790989
  NPD (past)

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

{
    "created_epoch": "1117584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387324800000",
    "number": "1114929486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "86 S COBB DR SE",
            "address_2": "MAIL DROP 0454",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300630454",
            "telephone_number": "770-494-5001",
            "fax_number": "770-494-7490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "86 S COBB DR SE",
            "address_2": "MAIL DROP 0454",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300630454",
            "telephone_number": "770-494-5001",
            "fax_number": "770-494-7490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "CHARLES",
        "middle_name": "WHITFIELD",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-01",
        "last_updated": "2013-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "MA51936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kendall Marie Callihan, APRN
• Hope Elen Callis, BCBA
• Logan Gregory Calvert, DC
• Cama Care Partners - Marietta, LLC
• Camelia Center
• Donald H Campbell, MD
• Ginnie Campbell, RN
• Ismay Campbell, D.C.
• Jeremy H Campbell, PT
• Julian H Campbell, DMD

• Family Medicine Physician in Marietta, GA
• Providers in Marietta, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2013; 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.