Provider Demographics
NPI:1558982603
Name:CAMPBELL, TAYLOR (MD)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:251 SOUTH CLAYBROOK ST.
Mailing Address - Street 2:STE A-206
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38104-3539
Mailing Address - Country:US
Mailing Address - Phone:901-516-7509
Mailing Address - Fax:901-516-7430
Practice Address - Street 1:251 SOUTH CLAYBROOK ST.
Practice Address - Street 2:STE A-206
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38104-3539
Practice Address - Country:US
Practice Address - Phone:901-516-7509
Practice Address - Fax:901-516-7430
Is Sole Proprietor?:No
Enumeration Date:2020-04-29
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TN70294207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program