Provider Demographics
NPI:1164750642
Name:TAMARA M. CAMPBELL MD.,PSYD, INC
Entity Type:Organization
Organization Name:TAMARA M. CAMPBELL MD.,PSYD, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TAMARA
Authorized Official - Middle Name:MILLER
Authorized Official - Last Name:CAMPBELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:513-961-8846
Mailing Address - Street 1:3001 HIGHLAND AVE
Mailing Address - Street 2:SUITE F
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45219-2315
Mailing Address - Country:US
Mailing Address - Phone:513-961-8846
Mailing Address - Fax:513-961-1530
Practice Address - Street 1:3001 HIGHLAND AVE
Practice Address - Street 2:SUITE F
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219-2315
Practice Address - Country:US
Practice Address - Phone:513-961-8846
Practice Address - Fax:513-961-1530
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-22
Last Update Date:2009-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35093160251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health