Provider Demographics
NPI:1003648429
Name:CAMPBELL, HALEY SHARP (DPT)
Entity type:Individual
Prefix:DR
First Name:HALEY
Middle Name:SHARP
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1868 RATCLIFF RD
Mailing Address - Street 2:
Mailing Address - City:SICILY ISLAND
Mailing Address - State:LA
Mailing Address - Zip Code:71368-4607
Mailing Address - Country:US
Mailing Address - Phone:318-531-9099
Mailing Address - Fax:
Practice Address - Street 1:495 JOHN R JUNKIN DR
Practice Address - Street 2:
Practice Address - City:NATCHEZ
Practice Address - State:MS
Practice Address - Zip Code:39120-3825
Practice Address - Country:US
Practice Address - Phone:601-600-2515
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-14
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA11910225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist