Provider Demographics
NPI:1396559662
Name:CAMPBELL, CRAIG ALEXANDER JR
Entity type:Individual
Prefix:
First Name:CRAIG
Middle Name:ALEXANDER
Last Name:CAMPBELL
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 TODD PL NE APT 1
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20002-1431
Mailing Address - Country:US
Mailing Address - Phone:757-995-3939
Mailing Address - Fax:
Practice Address - Street 1:429 KENNEDY ST NW APT 106
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-6526
Practice Address - Country:US
Practice Address - Phone:771-243-5854
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-05
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant