Provider Demographics
NPI:1336737964
Name:JOHN N CAMPBELL MD PC
Entity Type:Organization
Organization Name:JOHN N CAMPBELL MD PC
Other - Org Name:BIG RAPIDS CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNDER PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:N
Authorized Official - Last Name:CAMPBELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:616-455-9450
Mailing Address - Street 1:1676 VIEWPOND DR SE STE 100A
Mailing Address - Street 2:
Mailing Address - City:KENTWOOD
Mailing Address - State:MI
Mailing Address - Zip Code:49508-4994
Mailing Address - Country:US
Mailing Address - Phone:616-455-9450
Mailing Address - Fax:
Practice Address - Street 1:201 LINDEN ST
Practice Address - Street 2:
Practice Address - City:BIG RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49307-1825
Practice Address - Country:US
Practice Address - Phone:616-225-0202
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JOHN N CAMPBELL MD PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-01-08
Last Update Date:2021-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural HealthGroup - Single Specialty