Individual
DR. RICHARD D CAMPBELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1620 PRINCE AVE, ATHENS, GA 30606-6008
(770) 868-5644
(770) 868-5650
Mailing address
PO BOX 80883, ATHENS, GA 30608-0883
(706) 549-8114
(706) 549-0151
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
048030
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000906672
—
GA
01
—
0683833
CIGNA
GA
01
—
230000000
US DEPT. OF LABOR W/C
GA
01
—
464731
WELLCARE
GA
01
—
800610
BLUE CROSS
GA
01
—
P00631288
RAILROAD MEDICARE
GA
Enumeration date
11/09/2005
Last updated
02/22/2010
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