Individual
MR. KEVIN SCOTT CAMPBELL SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
722 LOUISIANA AVE, BOGALUSA, LA 70427
(985) 730-4357
(985) 730-5267
Mailing address
722 LOUISIANA AVE, BOGALUSA, LA 70427
(985) 730-4357
(985) 730-5267
Taxonomy
Speciality
Code
Description
License number
State
224P00000X
Prosthetist
Primary
—
LA
225000000X
Orthotic Fitter
—
LA
332B00000X
Durable Medical Equipment & Medical Supplies
—
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00440994
—
MS
05
—
1561312
—
LA
01
—
7214531530
BLUE CROSS BLUE SHIELD
LA
01
—
7214531530
BLUE CROSS BLUE SHIELD
MS
Enumeration date
02/16/2007
Last updated
01/16/2008
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