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C. E. Campbell JR., MD,PA
Specialist in Blytheville, Arkansas
NPI 1114934353

C. E. Campbell JR. is a Specialist based in Blytheville, AR. C. E. Campbell JR. practices in Blytheville, AR and has the professional credentials of MD,PA. The NPI Number for C. E. Campbell JR. is 1114934353 and holds a License No. R1755 (Arkansas).

The current practice location address for C. E. Campbell JR. is 609 Fulton St, Blytheville, AR and can be reached out via phone at 870-763-0855 and via fax at 870-763-0858.

Location: 609 Fulton St, Blytheville, AR, 72315-1922
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1114934353
Provider Name
C. E. Campbell JR.
Credential
MD,PA
Provider Entity Type
Individual
Gender
Male
Address
609 Fulton St, Blytheville, AR, 72315-1922
Phone Number
870-763-0855
Fax Number
870-763-0858
Provider Enumeration Date
08/01/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
103439001 05 AR
508807299 01 AR MEDICARE RENDERING #
1104017227 01 AR GROUP NPI
1114934353 01 AR INDIVIDUAL NPI
201045309 05 MO
50880 01 AR INDIVIDUAL BC/BS
R1755 01 AR STATE LICENSE
institution
Provider Business Practice Location Address Details
Address
609 Fulton St
City
Blytheville
State
Arkansas
Zip
72315-1922
Phone Number
870-763-0855
Fax Number
870-763-0858
person
Provider Business Mailing Address Details
Address
609 Fulton St
City
Blytheville
State
Arkansas
Zip
72315-1922
Phone Number
870-763-0855
Fax Number
870-763-0858
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
R1755 (Arkansas)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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