Provider Demographics
NPI:1477660454
Name:CAMPBELL, CAROL (MD)
Entity Type:Individual
Prefix:DR
First Name:CAROL
Middle Name:
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UTHSCSA, UTHSCSA, DEPT. ANESTHESIOLOGY
Mailing Address - Street 2:7703 FLOYD CURL DRIVE, RM 321.5E
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229
Mailing Address - Country:US
Mailing Address - Phone:210-567-4509
Mailing Address - Fax:210-358-4911
Practice Address - Street 1:UTHSCSA, UTHSCSA, DEPT. ANESTHESIOLOGY
Practice Address - Street 2:7703 FLOYD CURL DRIVE, RM 321.5E
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229
Practice Address - Country:US
Practice Address - Phone:210-567-4509
Practice Address - Fax:210-358-4911
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2011-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK6542207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX043807902Medicaid