Individual
KEITH CAMPBELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
650 JOEL DR, FORT CAMPBELL, KY 42223-5318
(314) 917-3734
Mailing address
650 JOEL DR, FORT CAMPBELL, KY 42223-5318
(314) 917-3734
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/20/2022
Last updated
10/16/2023
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