Provider Demographics
NPI:1467543637
Name:CAMPBELL, JOHN H (DC)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:H
Last Name:CAMPBELL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1330 OLD FREEPORT RD
Mailing Address - Street 2:SUITE 1BF
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15238-4100
Mailing Address - Country:US
Mailing Address - Phone:412-963-7464
Mailing Address - Fax:412-963-7409
Practice Address - Street 1:1330 OLD FREEPORT RD
Practice Address - Street 2:SUITE 1BF
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15238-4100
Practice Address - Country:US
Practice Address - Phone:412-963-7464
Practice Address - Fax:412-963-7409
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC001357L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA00821336Medicaid
PAT72684Medicare UPIN
PA00821336Medicaid