Individual
MR. THOMAS RAYMOND CAMPBELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
R. PH.
Contact information
Practice address
510 KINGS HWY, SHREVEPORT, LA 71104-4444
(318) 424-0896
(318) 424-0897
Mailing address
510 KINGS HWY, SHREVEPORT, LA 71104-4444
(318) 424-0896
(318) 424-0897
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
13420
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13420
PHARMACIST CERTIFICATE NUMBER
LA
Enumeration date
04/03/2012
Last updated
04/03/2012
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