Individual
MARY A MCCAMPBELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
6839 S CANTON AVE, TULSA, OK 74136-3402
(918) 494-0612
Mailing address
6839 S CANTON AVE, TULSA, OK 74136-3402
(832) 283-7391
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
1219
OK
363AM0700X
Medical Physician Assistant
PA05050
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8Y3325
BCBS
TX
Enumeration date
06/27/2005
Last updated
12/29/2022
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