Provider Demographics
NPI:1679676605
Name:CAMPBELL, PATRICK SCOTT (DC)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:SCOTT
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 1:5008 ATWOOD DR STE 4
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:KY
Mailing Address - Zip Code:40475-8184
Mailing Address - Country:US
Mailing Address - Phone:859-626-8833
Mailing Address - Fax:859-626-8832
Practice Address - Street 1:5008 ATWOOD DR STE 4
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:KY
Practice Address - Zip Code:40475-8184
Practice Address - Country:US
Practice Address - Phone:859-626-8833
Practice Address - Fax:859-626-8832
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-06
Last Update Date:2014-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4523111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY85002020Medicaid
U88375Medicare UPIN
KY6080704Medicare ID - Type Unspecified