Provider Demographics
NPI:1881911378
Name:CAMPBELL, WILLIAM T (MA)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:T
Last Name:CAMPBELL
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4125 SOMERSET DR
Mailing Address - Street 2:
Mailing Address - City:PRAIRIE VILLAGE
Mailing Address - State:KS
Mailing Address - Zip Code:66208-5242
Mailing Address - Country:US
Mailing Address - Phone:913-642-3311
Mailing Address - Fax:913-341-2654
Practice Address - Street 1:4125 SOMERSET DR
Practice Address - Street 2:
Practice Address - City:PRAIRIE VILLAGE
Practice Address - State:KS
Practice Address - Zip Code:66208-5242
Practice Address - Country:US
Practice Address - Phone:913-642-3311
Practice Address - Fax:913-341-2654
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-23
Last Update Date:2010-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSCE612237700000X
MO000541237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist