Charles W Campbell Md Pa | |
102 Carrollton Ave Lexington MS 39095-3250 | |
(662) 834-1721 | |
Not Available |
Full Name | Charles W Campbell Md Pa |
---|---|
Speciality | Clinic/center - Primary Care |
Location | 102 Carrollton Ave, Lexington, Mississippi |
Authorized Official Name and Position | Charles W Campbell (OWNER) |
Authorized Official Contact | 6628341722 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Charles W Campbell Md Pa 102 Carrollton Ave Lexington MS 39095-3250 Ph: (662) 834-1721 | Charles W Campbell Md Pa 102 Carrollton Ave Lexington MS 39095-3250 Ph: (662) 834-1721 |
NPI Number | 1891907440 |
---|---|
Provider Enumeration Date | 05/04/2007 |
Last Update Date | 06/25/2015 |
Identifier | Type | State | Issuer |
---|---|---|---|
1891907440 | NPI | - | NPPES |
09014433 | Medicaid | MS | |
02187313 | Medicaid | MS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | 04488 (Mississippi) | Primary |
Mallory Community Health Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 17280 Highway 17, Lexington, MS 39095 Phone: 662-834-1857 Fax: 662-834-1859 | |