Provider Demographics
NPI:1629078266
Name:CAMPBELL, JAMES CLYDE (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:CLYDE
Last Name:CAMPBELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1601 W 40TH AVE
Mailing Address - Street 2:SUITE 301
Mailing Address - City:PINE BLUFF
Mailing Address - State:AR
Mailing Address - Zip Code:71603-6319
Mailing Address - Country:US
Mailing Address - Phone:870-541-4280
Mailing Address - Fax:870-541-4297
Practice Address - Street 1:1601 W 40TH AVE
Practice Address - Street 2:SUITE 301
Practice Address - City:PINE BLUFF
Practice Address - State:AR
Practice Address - Zip Code:71603-6319
Practice Address - Country:US
Practice Address - Phone:870-541-4280
Practice Address - Fax:870-541-4297
Is Sole Proprietor?:No
Enumeration Date:2005-07-26
Last Update Date:2016-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARC-4368207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5404145OtherAETNA
AR102986001Medicaid
AR50887OtherBCBS
AR15457000000OtherQUAL CHOICE
AR102986001Medicaid
AR5404145OtherAETNA