Provider Demographics
NPI:1144335365
Name:JAMES A. CAMPBELL MD & ASSOCIATES PC
Entity type:Organization
Organization Name:JAMES A. CAMPBELL MD & ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:A
Authorized Official - Last Name:CAMPBELL
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:870-535-7070
Mailing Address - Street 1:1706 W 42ND AVE
Mailing Address - Street 2:
Mailing Address - City:PINE BLUFF
Mailing Address - State:AR
Mailing Address - Zip Code:71603-7008
Mailing Address - Country:US
Mailing Address - Phone:870-535-7070
Mailing Address - Fax:870-535-5054
Practice Address - Street 1:1706 W 42ND AVE
Practice Address - Street 2:
Practice Address - City:PINE BLUFF
Practice Address - State:AR
Practice Address - Zip Code:71603-7008
Practice Address - Country:US
Practice Address - Phone:870-535-7070
Practice Address - Fax:870-535-5054
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-20
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR390002585OtherPALMETTO GBA - RAILROAD MEDICARE
AR123962002Medicaid
AR5G010Medicare PIN
ARE92690Medicare UPIN