Provider Demographics
NPI:1235161555
Name:CAMPBELL, RONALD K (OD)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:K
Last Name:CAMPBELL
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1071
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:NC
Mailing Address - Zip Code:28744-1071
Mailing Address - Country:US
Mailing Address - Phone:828-631-0903
Mailing Address - Fax:828-586-3386
Practice Address - Street 1:210 WALMART PLZ
Practice Address - Street 2:SUITE 5
Practice Address - City:SYLVA
Practice Address - State:NC
Practice Address - Zip Code:28779-5866
Practice Address - Country:US
Practice Address - Phone:828-631-0903
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2016-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1359152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0912EOtherBSBC PROVIDER NUMBER
NC890912EMedicaid
NC0912EOtherBSBC PROVIDER NUMBER
NC890912EMedicaid