Provider Demographics
NPI:1649263641
Name:CAMPBELL, WILLIAM KEITH (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:KEITH
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:PO BOX 950
Mailing Address - Street 2:
Mailing Address - City:WEAVERVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28787-0950
Mailing Address - Country:US
Mailing Address - Phone:828-645-3066
Mailing Address - Fax:828-658-3944
Practice Address - Street 1:63 MONTICELLO RD
Practice Address - Street 2:
Practice Address - City:WEAVERVILLE
Practice Address - State:NC
Practice Address - Zip Code:28787-0950
Practice Address - Country:US
Practice Address - Phone:828-645-3066
Practice Address - Fax:828-658-3944
Is Sole Proprietor?:No
Enumeration Date:2005-08-24
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0000-20774207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC20990OtherBCBS
NC01-70263OtherUNITED HEALTH CARE
NC89-20990Medicaid
NC89-20990Medicaid
NCC83125Medicare UPIN
NC20990OtherBCBS
NC0144030001Medicare NSC
NC080051075Medicare PIN