Provider Demographics
NPI:1255343216
Name:CAMPBELL, LADD MATHEW (DO)
Entity type:Individual
Prefix:
First Name:LADD
Middle Name:MATHEW
Last Name:CAMPBELL
Suffix:
Gender:M
Credentials:DO
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Other - Credentials:
Mailing Address - Street 1:979 E 3RD ST
Mailing Address - Street 2:STE C235
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37403-3309
Mailing Address - Country:US
Mailing Address - Phone:423-602-8400
Mailing Address - Fax:423-602-8401
Practice Address - Street 1:76 PEACHTREE RD
Practice Address - Street 2:SUITE 300
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-3131
Practice Address - Country:US
Practice Address - Phone:828-254-1969
Practice Address - Fax:828-771-5242
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2016-08-31
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Provider Licenses
StateLicense IDTaxonomies
TNDO1707207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
I33579Medicare UPIN