Provider Demographics
NPI:1225171168
Name:CAMPBELLS EYECARE PLLC
Entity Type:Organization
Organization Name:CAMPBELLS EYECARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CARRIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:CAMPBELL
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:269-639-2060
Mailing Address - Street 1:1801 WILLIAMSBURG DR
Mailing Address - Street 2:
Mailing Address - City:STEVENSVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:49127
Mailing Address - Country:US
Mailing Address - Phone:269-639-2060
Mailing Address - Fax:269-639-2154
Practice Address - Street 1:201 73RD ST
Practice Address - Street 2:
Practice Address - City:S HAVEN
Practice Address - State:MI
Practice Address - Zip Code:49090-7907
Practice Address - Country:US
Practice Address - Phone:269-639-2060
Practice Address - Fax:269-639-2154
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901004349152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty