Provider Demographics
NPI:1518146117
Name:CAMPBELL, DAVID W (DC)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:W
Last Name:CAMPBELL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1034 N GILBERT RD STE 1
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85234-3381
Mailing Address - Country:US
Mailing Address - Phone:480-539-2774
Mailing Address - Fax:
Practice Address - Street 1:1034 N GILBERT RD STE 1
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85234-3381
Practice Address - Country:US
Practice Address - Phone:480-539-2774
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-31
Last Update Date:2007-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7870111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor