Organization
MICHAEL L CAMPBELL MD PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL L CAMPBELL M.D. (PRESIDENT)
(270) 842-1660
Entity
Organization
Contact information
Practice address
1325 ANDREA ST, SUITE 209, BOWLING GREEN, KY 42104-5852
(270) 842-1660
(270) 843-1911
Mailing address
1325 ANDREA ST, SUITE 209, BOWLING GREEN, KY 42104-5852
(270) 842-1660
(270) 843-1911
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
41068
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00650001
MEDICARE
KY
01
—
1700924743
INDIVIDUAL NPI
KY
01
—
41068
KY STATE LICENSE
KY
05
—
7100043530
—
KY
Enumeration date
06/09/2008
Last updated
12/30/2008
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