Provider Demographics
NPI:1336209170
Name:CAMPBELL, MICHAEL F (MS)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:F
Last Name:CAMPBELL
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 CANAL ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70119-6535
Mailing Address - Country:US
Mailing Address - Phone:504-507-6435
Mailing Address - Fax:504-507-6427
Practice Address - Street 1:5900 SUMMIT AVE STE 103
Practice Address - Street 2:
Practice Address - City:BROWNS SUMMIT
Practice Address - State:NC
Practice Address - Zip Code:27214-9859
Practice Address - Country:US
Practice Address - Phone:336-217-5120
Practice Address - Fax:336-217-5127
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2020-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4475235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist