Provider Demographics
NPI:1801957121
Name:DOUGLAS G CAMPBELL MD - BATTLE CREEK HEALTH SYSTEM
Entity type:Organization
Organization Name:DOUGLAS G CAMPBELL MD - BATTLE CREEK HEALTH SYSTEM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHARI
Authorized Official - Middle Name:
Authorized Official - Last Name:CHANEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:269-966-8302
Mailing Address - Street 1:363 FREMONT ST
Mailing Address - Street 2:SUITE 302
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49017-3389
Mailing Address - Country:US
Mailing Address - Phone:269-979-6330
Mailing Address - Fax:269-966-8305
Practice Address - Street 1:363 FREMONT ST
Practice Address - Street 2:SUITE 302
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49017-3389
Practice Address - Country:US
Practice Address - Phone:269-979-6330
Practice Address - Fax:269-966-8305
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIDC041491207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
B46744Medicare UPIN