Provider Demographics
NPI:1528403144
Name:CAMPBELL SURGICAL PLLC
Entity Type:Organization
Organization Name:CAMPBELL SURGICAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MBR
Authorized Official - Prefix:
Authorized Official - First Name:F
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:CAMPBELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:704-663-7905
Mailing Address - Street 1:123 PROFESSIONAL PARK DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28117-5516
Mailing Address - Country:US
Mailing Address - Phone:704-534-3336
Mailing Address - Fax:704-360-4954
Practice Address - Street 1:123 PROFESSIONAL PARK DR
Practice Address - Street 2:SUITE 101
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28117-5516
Practice Address - Country:US
Practice Address - Phone:704-663-7905
Practice Address - Fax:704-360-4954
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-09
Last Update Date:2013-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty