Provider Demographics
NPI:1811241581
Name:CAMPBELL, CAMDEN H (DPT)
Entity type:Individual
Prefix:
First Name:CAMDEN
Middle Name:H
Last Name:CAMPBELL
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:251 MEDICAL PLAZA LN
Mailing Address - Street 2:SUITE D
Mailing Address - City:WHITESBURG
Mailing Address - State:KY
Mailing Address - Zip Code:41858-9323
Mailing Address - Country:US
Mailing Address - Phone:606-632-1188
Mailing Address - Fax:606-632-0075
Practice Address - Street 1:6800 US HIGHWAY 23 S
Practice Address - Street 2:SUITE 4
Practice Address - City:PIKEVILLE
Practice Address - State:KY
Practice Address - Zip Code:41501-3701
Practice Address - Country:US
Practice Address - Phone:606-639-1200
Practice Address - Fax:606-639-1020
Is Sole Proprietor?:No
Enumeration Date:2012-11-02
Last Update Date:2013-08-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY006245225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist