Individual
DR. KENT A CAMPBELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
12255 DE PAUL DR, SUITE 200, BRIDGETON, MO 63044-2510
(314) 344-7600
(314) 344-7850
Mailing address
12255 DE PAUL DR, SUITE 200, BRIDGETON, MO 63044-2510
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MOR1E21
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00035726
RAILROAD MEDICARE
MO
Enumeration date
02/10/2006
Last updated
03/14/2008
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