Provider Demographics
NPI:1710986682
Name:CAMPBELL, TODD C (MD)
Entity Type:Individual
Prefix:
First Name:TODD
Middle Name:C
Last Name:CAMPBELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:880 CENTURY DRIVE
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17055
Mailing Address - Country:US
Mailing Address - Phone:717-691-3235
Mailing Address - Fax:717-691-3243
Practice Address - Street 1:880 CENTURY DRIVE
Practice Address - Street 2:
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17055
Practice Address - Country:US
Practice Address - Phone:717-691-3235
Practice Address - Fax:717-691-3243
Is Sole Proprietor?:No
Enumeration Date:2005-07-21
Last Update Date:2009-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200300950208600000X
PAMD428316208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1015292910001Medicaid
PA1250401OtherAETNA HMO
PA30033052OtherKEYSTONE MERCY
PA37167OtherHEALTH PARTNERS
NC201093283OtherGROUP TAX ID #
PA101529291001Medicaid
PA10152929101OtherAMERICHOICE
PA7211833OtherAETNA
NC891347VMedicaid
PA2702925000OtherBCBS
PA83031939OtherCIGNA
PAH91150Medicare UPIN
PA1015292910001Medicaid
PA10152929101OtherAMERICHOICE
PA2702925000OtherBCBS
PA102063VGUMedicare PIN