Provider Demographics
NPI:1851169668
Name:CAMPBELL, CALEB (HIS)
Entity Type:Individual
Prefix:
First Name:CALEB
Middle Name:
Last Name:CAMPBELL
Suffix:
Gender:M
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:66 TROTTING HILL LN
Mailing Address - Street 2:
Mailing Address - City:BLUFFTON
Mailing Address - State:SC
Mailing Address - Zip Code:29910-7615
Mailing Address - Country:US
Mailing Address - Phone:843-473-5104
Mailing Address - Fax:
Practice Address - Street 1:1505 MAIN ST
Practice Address - Street 2:
Practice Address - City:HILTON HEAD
Practice Address - State:SC
Practice Address - Zip Code:29926-1608
Practice Address - Country:US
Practice Address - Phone:843-547-5832
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-12
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCHAS-0743237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist