Individual
JACOB DALE CAMPBELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
UCONN SCHOOL OF MEDICINE DEPT OF SURGERY, 263 FARMINGTON AVE, FARMINGTON, CT 06030-3955
(860) 679-2147
(860) 679-4624
Mailing address
UCONN SCHOOL OF MEDICINE DEPT OF SURGERY, 263 FARMINGTON AVE, FARMINGTON, CT 06030-3955
(860) 679-2147
(860) 679-4624
Taxonomy
Speciality
Code
Description
License number
State
2086S0120X
Pediatric Surgery Physician
Primary
75461
CT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/12/2014
Last updated
11/20/2023
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