Provider Demographics
NPI:1093794497
Name:CAMPBELL, ALLEN S (MD)
Entity Type:Individual
Prefix:
First Name:ALLEN
Middle Name:S
Last Name:CAMPBELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:2006 FRANKLIN ST SE
Mailing Address - Street 2:STE 301
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-4551
Mailing Address - Country:US
Mailing Address - Phone:256-539-9471
Mailing Address - Fax:256-539-9472
Practice Address - Street 1:101 SIVLEY RD SW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-4421
Practice Address - Country:US
Practice Address - Phone:256-265-1000
Practice Address - Fax:256-539-9472
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-13
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL00012445207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4011019OtherBCBS TN
AL51024085OtherBCBS
AL51523596OtherBCBS - MASC
TN4011019OtherBCBS TN