Provider Demographics
NPI:1851593990
Name:CAMPBELL, LUCAS KYLE (MD)
Entity Type:Individual
Prefix:DR
First Name:LUCAS
Middle Name:KYLE
Last Name:CAMPBELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:390 E LONGVIEW ST
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72703-4618
Mailing Address - Country:US
Mailing Address - Phone:479-442-0144
Mailing Address - Fax:479-442-4557
Practice Address - Street 1:390 E LONGVIEW ST
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703-4618
Practice Address - Country:US
Practice Address - Phone:479-442-0144
Practice Address - Fax:479-442-4557
Is Sole Proprietor?:No
Enumeration Date:2007-06-01
Last Update Date:2010-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ARE-5306207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology