Provider Demographics
NPI:1114951092
Name:CAMPBELL, DOUGLAS M (MD)
Entity Type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:M
Last Name:CAMPBELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6 SAN REMO DR.
Mailing Address - Street 2:UVM MEDICAL CENTER - ORTHOPEDICS
Mailing Address - City:S. BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05403
Mailing Address - Country:US
Mailing Address - Phone:802-862-3983
Mailing Address - Fax:802-863-7994
Practice Address - Street 1:6 SAN REMO DR.
Practice Address - Street 2:UVM MEDICAL CENTER - ORTHOPEDICS
Practice Address - City:S. BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05403
Practice Address - Country:US
Practice Address - Phone:802-862-3983
Practice Address - Fax:802-863-7994
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2016-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT42-0007452207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
C65547Medicare UPIN