Provider Demographics
NPI:1508838913
Name:DONALD B CAMPBELL MD INC
Entity Type:Organization
Organization Name:DONALD B CAMPBELL MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MGR
Authorized Official - Prefix:MS
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:E
Authorized Official - Last Name:JAGODZINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-479-2645
Mailing Address - Street 1:2109 HUGHES
Mailing Address - Street 2:STE 620
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43606
Mailing Address - Country:US
Mailing Address - Phone:419-479-2645
Mailing Address - Fax:419-479-6002
Practice Address - Street 1:2109 HUGHES
Practice Address - Street 2:STE 620
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43606
Practice Address - Country:US
Practice Address - Phone:419-479-2645
Practice Address - Fax:419-479-6002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35030613C208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0302050Medicaid
A74268Medicare UPIN
OH0302050Medicaid