Provider Demographics
NPI:1043270143
Name:CAMPBELL, HIGHLAND R JR (MD)
Entity Type:Individual
Prefix:
First Name:HIGHLAND
Middle Name:R
Last Name:CAMPBELL
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:551 MAIN ST 3RD FLOOR ATTN NICOLLE
Mailing Address - Street 2:THE INFORMEDX GROUP
Mailing Address - City:JOHNSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15901
Mailing Address - Country:US
Mailing Address - Phone:814-539-5724
Mailing Address - Fax:814-536-7092
Practice Address - Street 1:401 HORSHAM RD
Practice Address - Street 2:
Practice Address - City:HORSHAM
Practice Address - State:PA
Practice Address - Zip Code:19044-2013
Practice Address - Country:US
Practice Address - Phone:215-422-3646
Practice Address - Fax:484-944-1523
Is Sole Proprietor?:No
Enumeration Date:2006-03-24
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD422335207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA100904932Medicaid
PA077757Medicare ID - Type Unspecified