Provider Demographics
NPI:1578692133
Name:CAMPBELL, LINDA JUNE IX (MD,ABIM)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:JUNE
Last Name:CAMPBELL
Suffix:IX
Gender:F
Credentials:MD,ABIM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 SIENNA DR
Mailing Address - Street 2:
Mailing Address - City:CHAPIN
Mailing Address - State:SC
Mailing Address - Zip Code:29036-8680
Mailing Address - Country:US
Mailing Address - Phone:803-240-5549
Mailing Address - Fax:
Practice Address - Street 1:338 E COLUMBIA AVE STE B
Practice Address - Street 2:
Practice Address - City:LEESVILLE
Practice Address - State:SC
Practice Address - Zip Code:29070-9285
Practice Address - Country:US
Practice Address - Phone:803-532-1580
Practice Address - Fax:803-532-3832
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2009-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC14473207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCE6220Medicare UPIN