Provider Demographics
NPI:1578562666
Name:CAMPBELL, THOMAS W (DC)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:W
Last Name:CAMPBELL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:185 PASADENA DR
Mailing Address - Street 2:STE 210
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-2969
Mailing Address - Country:US
Mailing Address - Phone:859-254-5001
Mailing Address - Fax:859-255-3248
Practice Address - Street 1:185 PASADENA DR
Practice Address - Street 2:STE 210
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-2969
Practice Address - Country:US
Practice Address - Phone:859-254-5001
Practice Address - Fax:859-255-3248
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-20
Last Update Date:2016-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4573111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000289509OtherANTHEM
KY7960574OtherAETNA
KY1204607OtherCHA HEALTH
KY2278549OtherFIRST HEALTH
KY7960574OtherAETNA