Provider Demographics
NPI:1518577568
Name:JOHN N CAMPBELL MD PC
Entity Type:Organization
Organization Name:JOHN N CAMPBELL MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:N
Authorized Official - Last Name:CAMPBELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:616-455-9450
Mailing Address - Street 1:1676 VIEWPOND DR SE STE 100A
Mailing Address - Street 2:
Mailing Address - City:KENTWOOD
Mailing Address - State:MI
Mailing Address - Zip Code:49508-4994
Mailing Address - Country:US
Mailing Address - Phone:616-455-9450
Mailing Address - Fax:616-455-5221
Practice Address - Street 1:811 E KENT RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:MI
Practice Address - Zip Code:48838-9791
Practice Address - Country:US
Practice Address - Phone:616-225-0202
Practice Address - Fax:616-225-0207
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JOHN N CAMPBELL MD PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-08-05
Last Update Date:2020-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health