Individual
PATRICIA LURLINE CAMPBELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1146 EVELYN GANDY PKWY, PETAL, MS 39465-3947
(601) 584-4309
Mailing address
1146 EVELYN GANDY PKWY, PETAL, MS 39465-3947
(601) 584-4309
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
30585
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
30585
MEDICAL LICENSE
MS
Enumeration date
06/20/2019
Last updated
08/25/2022
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