Provider Demographics
NPI:1982675195
Name:CAMPBELL, JAMES WILLOUGHBY (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:WILLOUGHBY
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 1:1900 MALVERN AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71901-7759
Mailing Address - Country:US
Mailing Address - Phone:501-624-5700
Mailing Address - Fax:501-624-6519
Practice Address - Street 1:1900 MALVERN AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71901-7759
Practice Address - Country:US
Practice Address - Phone:501-624-5700
Practice Address - Fax:501-624-6519
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-27
Last Update Date:2012-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARC4921208600000X, 2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR50888OtherBCBS
AR102430001Medicaid
ARC67954Medicare UPIN
AR102430001Medicaid