Provider Demographics
NPI:1558459453
Name:CAMPBELL, JOHN WHITE III (MD)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:WHITE
Last Name:CAMPBELL
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 SPRINGHALL DR
Mailing Address - Street 2:
Mailing Address - City:GOOSE CREEK
Mailing Address - State:SC
Mailing Address - Zip Code:29445-5335
Mailing Address - Country:US
Mailing Address - Phone:843-820-1222
Mailing Address - Fax:843-377-0391
Practice Address - Street 1:100 SPRINGHALL DR
Practice Address - Street 2:
Practice Address - City:GOOSE CREEK
Practice Address - State:SC
Practice Address - Zip Code:29445-5335
Practice Address - Country:US
Practice Address - Phone:843-820-1222
Practice Address - Fax:843-377-0391
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2008-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC27190207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC271903Medicaid
SCAA2020Medicare UPIN
SC271903Medicaid
SC3163Medicare PIN