Individual
DR. LOWELL MASON CAMPBELL III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSYD, LP
Contact information
Practice address
287 MARSCHALL RD STE 203, SHAKOPEE, MN 55379-1678
(952) 445-1397
(952) 445-1398
Mailing address
287 MARSCHALL RD STE 203, PO BOX 336, SHAKOPEE, MN 55379-1678
(952) 445-1397
(952) 445-1398
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP2631
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01010981
PREFERRED ONE
MN
01
—
1346259041
IND NPI#
MN
01
—
51053CA
BCBS ID
MN
01
—
51217CA
BCBS GROUP ID
MN
01
—
61-20043
MEDICA ID
MN
01
—
HP19455
HEALTHPARTNERS
MN
Enumeration date
07/25/2006
Last updated
11/15/2007
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