Individual
MR. JONATHAN CROSS CAMPBELL III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5320 HIGHWAY 90 W, MOBILE, AL 36619-4202
(251) 666-8232
Mailing address
7505 MOFFETT RD, MOBILE, AL 36618-4193
(251) 649-6112
(251) 649-6115
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
15993
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
051519758
BLUE CROSS BLUE SHIELD
AL
01
—
P00111807
RAILROAD MEDICARE
AL
Enumeration date
03/02/2006
Last updated
07/11/2019
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