Provider Demographics
NPI:1639196157
Name:CAMPBELL, JOHN CHRISTY (MA)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:CHRISTY
Last Name:CAMPBELL
Suffix:
Gender:M
Credentials:MA
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Mailing Address - Street 1:1100 N COLLEGE AVE
Mailing Address - Street 2:VAMC FAYETTEVILLE AUDIOLOGY/126
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72703-1944
Mailing Address - Country:US
Mailing Address - Phone:479-443-4301
Mailing Address - Fax:479-587-5823
Practice Address - Street 1:1100 N COLLEGE AVE
Practice Address - Street 2:VAMC FAYETTEVILLE AUDIOLOGY/126
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703-1944
Practice Address - Country:US
Practice Address - Phone:479-443-4301
Practice Address - Fax:479-587-5823
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ARA#212231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist