Tom Edward Campbell, M.D.

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

35-03-8186 Issued in OH

Practice address

590 E Western Reserve Rd
Building 5
Poland, OH 44514-3354

Phone

(330) 965-9954

Fax

(330) 965-9958

NPI assigned

Oct 28, 2005

Last updated

Mar 12, 2008By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1130457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205280000000",
    "number": "1992796023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7111 FAIRWAY DR",
            "address_2": "SUITE 400",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334184204",
            "telephone_number": "800-330-6565",
            "fax_number": "440-703-2155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "590 E WESTERN RESERVE RD",
            "address_2": "BUILDING 5",
            "city": "POLAND",
            "state": "OH",
            "postal_code": "445143354",
            "telephone_number": "330-965-9954",
            "fax_number": "330-965-9958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "TOM",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-28",
        "last_updated": "2008-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "OH",
            "license": "35-03-8186",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0533159",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Anatomic Pathology & Clinical Pathology Physician in Poland, OH
• Providers in Poland, OH by specialty
• Anatomic Pathology & Clinical Pathology Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2008; 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.