| 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 |
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