Individual
JOHNNY PHILLIPS CAMPBELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
316 CALHOUN ST, CHARLESTON, SC 29401-1113
(843) 724-2988
Mailing address
PO BOX 2363, INDIANAPOLIS, IN 46206-2363
(843) 724-2154
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
28443
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00396969
RR MEDICARE
SC
05
—
Q01611
—
SC
Enumeration date
06/20/2006
Last updated
02/14/2014
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