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Individual

DR. JASON LAYNE CAMPBELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1505 E BERT KOUNS INDUSTRIAL LOOP STE 201, SHREVEPORT, LA 71105-5723
(318) 681-4103
Mailing address
PO BOX 9600, DEPT 09-038, TEXARKANA, TX 75505-9600
(877) 243-8416

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
2007013152
MO
2085R0202X
Diagnostic Radiology Physician
Primary
202098
LA
2085R0202X
Diagnostic Radiology Physician
4301080056
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1365807
LA
Enumeration date
05/22/2007
Last updated
04/21/2025
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