Provider Demographics
NPI:1508186867
Name:CAMPBELL, CRAIG O'NEIL (MD)
Entity Type:Individual
Prefix:
First Name:CRAIG
Middle Name:O'NEIL
Last Name:CAMPBELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1525 PACEVILLE CT
Mailing Address - Street 2:
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30012-7125
Mailing Address - Country:US
Mailing Address - Phone:404-903-8223
Mailing Address - Fax:404-720-8200
Practice Address - Street 1:1525 PACEVILLE CT
Practice Address - Street 2:
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30012-7125
Practice Address - Country:US
Practice Address - Phone:404-903-8223
Practice Address - Fax:404-720-8200
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA069773207RH0002X, 208D00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice