Provider Demographics
NPI:1205845765
Name:MCCAMPBELL, MARCIA (MD)
Entity type:Individual
Prefix:
First Name:MARCIA
Middle Name:
Last Name:MCCAMPBELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 BUTTE ST
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96001-0852
Mailing Address - Country:US
Mailing Address - Phone:530-244-8349
Mailing Address - Fax:530-244-5488
Practice Address - Street 1:1100 BUTTE ST
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-0852
Practice Address - Country:US
Practice Address - Phone:530-244-8349
Practice Address - Fax:530-244-5488
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2009-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG87443207RN0300X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G874430Medicaid
CA00G874430Medicare ID - Type Unspecified
CA00G874430Medicaid