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Individual

JOHN KACHLER CAMPBELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2910 ROYAL FORREST DR, RALEIGH, NC 27614-7651
(919) 782-4894
Mailing address
2910 ROYAL FORREST DR, RALEIGH, NC 27614-7651
(919) 782-4894

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2010-01797
NC
207Q00000X
Family Medicine Physician
ME63053
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
080116174
RR MEDICARE
FL
05
375803600
FL
05
5916307
NC
Enumeration date
10/19/2005
Last updated
11/04/2024
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