Provider Demographics
NPI:1053686287
Name:CAMPBELL, DAVID SCOTHORN (DO)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:SCOTHORN
Last Name:CAMPBELL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3761 EMBASSY CIR
Mailing Address - Street 2:
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34685-1017
Mailing Address - Country:US
Mailing Address - Phone:727-787-5796
Mailing Address - Fax:727-787-5796
Practice Address - Street 1:3761 EMBASSY CIR
Practice Address - Street 2:
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34685-1017
Practice Address - Country:US
Practice Address - Phone:727-787-5796
Practice Address - Fax:727-787-5796
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-21
Last Update Date:2012-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS1853208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice