Provider Demographics
NPI:1669453767
Name:CAMPBELL, JOHN (DO)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:CAMPBELL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
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Mailing Address - Street 1:805 E LEE ST STE C
Mailing Address - Street 2:ENTERPRISE CLINIC, LLC/DBA ENTERPRISE EXPRESS CARE
Mailing Address - City:ENTERPRISE
Mailing Address - State:AL
Mailing Address - Zip Code:36330-2477
Mailing Address - Country:US
Mailing Address - Phone:334-348-8818
Mailing Address - Fax:
Practice Address - Street 1:805 E LEE ST STE C
Practice Address - Street 2:ENTERPRISE CLINIC, LLC/DBA ENTERPRISE EXPRESS CARE
Practice Address - City:ENTERPRISE
Practice Address - State:AL
Practice Address - Zip Code:36330-2477
Practice Address - Country:US
Practice Address - Phone:334-348-8818
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-07
Last Update Date:2015-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALDO-8012083A0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083A0100XAllopathic & Osteopathic PhysiciansPreventive MedicineAerospace Medicine