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Individual

MARC W CAMPBELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1415 TIMBER CREEK DR, JASPER, IN 47546-1413
(812) 630-9794
(812) 996-0653
Mailing address
PO BOX 3276, EVANSVILLE, IN 47731-3276
(812) 473-0181
(812) 473-5822

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01036961A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000537927
ANTHEM PIN
IN
05
100338320
IN
01
200859330C
MEDICAID GROUP
IN
01
250470
MEDICARE GROUP
IN
Enumeration date
04/11/2006
Last updated
08/30/2022
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