Provider Demographics
NPI:1780754226
Name:CAMPBELL, JAMES W JR (DC)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:W
Last Name:CAMPBELL
Suffix:JR
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 1:3 AUER CT STE D
Mailing Address - Street 2:
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-5825
Mailing Address - Country:US
Mailing Address - Phone:732-254-2273
Mailing Address - Fax:732-254-1533
Practice Address - Street 1:3 AUER CT STE D
Practice Address - Street 2:
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-5825
Practice Address - Country:US
Practice Address - Phone:732-254-2273
Practice Address - Fax:732-254-1533
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-09
Last Update Date:2007-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00369400111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJU01800Medicare UPIN
NJCA619037Medicare PIN