Provider Demographics
NPI:1568753143
Name:CAMPBELL, CHASE LEE (MD)
Entity Type:Individual
Prefix:
First Name:CHASE
Middle Name:LEE
Last Name:CAMPBELL
Suffix:
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 1:131 E MARKET ST
Mailing Address - Street 2:
Mailing Address - City:SMITHFIELD
Mailing Address - State:NC
Mailing Address - Zip Code:27577-3915
Mailing Address - Country:US
Mailing Address - Phone:919-934-5441
Mailing Address - Fax:919-934-0152
Practice Address - Street 1:131 E MARKET ST
Practice Address - Street 2:
Practice Address - City:SMITHFIELD
Practice Address - State:NC
Practice Address - Zip Code:27577-3915
Practice Address - Country:US
Practice Address - Phone:919-934-5441
Practice Address - Fax:919-934-0152
Is Sole Proprietor?:No
Enumeration Date:2011-04-29
Last Update Date:2016-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC172717208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery