Organization
CAMPBELL CLINIC, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DANIEL SHUMATE (CEO)
(901) 759-3100
Entity
Organization
Contact information
Practice address
1400 S GERMANTOWN RD, GERMANTOWN, TN 38138-2205
(901) 759-3100
Mailing address
1400 S GERMANTOWN RD, GERMANTOWN, TN 38138-2205
(901) 759-3100
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207T00000X
Neurological Surgery Physician
—
—
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
213ES0131X
Foot Surgery Podiatrist
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09010261
—
MS
05
—
107015002
—
AR
05
—
3373783
—
TN
01
—
81355
BLUE CROSS BLUE SHIELD AR
AR
Enumeration date
07/19/2006
Last updated
06/13/2025
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