Individual
WILLIAM B CAMPBELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
105A RIDGECREST, NIXA, MO 65714-7807
(417) 725-8250
(417) 725-8253
Mailing address
105A RIDGECREST, NIXA, MO 65714-7807
(417) 725-8250
(417) 725-8253
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
R2D18
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
241836204
—
MO
01
—
P00174740
RR MEDICARE
—
Enumeration date
08/15/2005
Last updated
03/17/2009
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