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Individual

GEORGE CAMPBELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
315 S SOMERVILLE ST, MEMPHIS, TN 38104-3352
(901) 827-0571
(500) 594-5717
Mailing address
315 DR. MARTIN LUTHER KING DR., MEMPHIS, TN 38104
(901) 827-0571
(800) 594-5117

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1000000014991
TN
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1000000015350
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
Q009263
TN
Enumeration date
12/11/2014
Last updated
12/11/2014
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