Provider Demographics
NPI:1821066341
Name:CAMPBELL, EARL V JR (MD)
Entity Type:Individual
Prefix:
First Name:EARL
Middle Name:V
Last Name:CAMPBELL
Suffix:JR
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 1:2410 PATTERSON ST
Mailing Address - Street 2:SUITE 402
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-1551
Mailing Address - Country:US
Mailing Address - Phone:615-322-9593
Mailing Address - Fax:615-322-9240
Practice Address - Street 1:2410 PATTERSON ST
Practice Address - Street 2:SUITE 402
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-1551
Practice Address - Country:US
Practice Address - Phone:615-322-9593
Practice Address - Fax:615-322-9240
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-10
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD024721207R00000X, 207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Not Answered207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Not Answered207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3078907Medicaid
TN3078907Medicare ID - Type Unspecified
F05778Medicare UPIN