Doctor Name: | MATTHEW RYAN CAMPBELL |
NPI Number: | 1558431494 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | MD 14023 |
Business Practice Address: | Besf Apo, AE - 09348 |
Business Phone Number: | 7036734258 |
Business Fax Number: | |
Mailing Address: | 1530 P B Lane, Pmb C217 WICHITA FALLS |
State: | TX |
Postal Code: | 76302 |
Phone Number: | 7036734258 |
Fax Number: | |
NPI Enumeration Date: | 11/08/2006 |
NPI Last Update Date: | 07/17/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | MD 14023 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | HI |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |