Individual
CHASE CAMPBELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1400 E BOULDER ST, COLORADO SPRINGS, CO 80909
(719) 365-5000
(719) 591-2745
Mailing address
PO BOX 912688, DENVER, CO 80291-2688
(877) 406-2916
(719) 591-2745
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
BP10043077
TX
2085R0202X
Diagnostic Radiology Physician
Primary
DR.0059707
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1306106562
—
CO
01
—
651158
MEDICARE
CO
01
—
P02023278
RR MEDICARE
—
Enumeration date
05/22/2012
Last updated
01/10/2019
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