Provider Demographics
NPI:1912903519
Name:CAMPBELL, JOSEPH F (DPM)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:F
Last Name:CAMPBELL
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:JOSEPH
Other - Middle Name:F
Other - Last Name:CAMPBELL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DPM
Mailing Address - Street 1:16251 N CLEVELAND AVE
Mailing Address - Street 2:STE 7
Mailing Address - City:N FT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33903-2176
Mailing Address - Country:US
Mailing Address - Phone:239-656-6565
Mailing Address - Fax:239-656-3081
Practice Address - Street 1:16251 N CLEVELAND AVE
Practice Address - Street 2:STE 7
Practice Address - City:N FT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33903-2176
Practice Address - Country:US
Practice Address - Phone:239-656-6565
Practice Address - Fax:239-656-3081
Is Sole Proprietor?:No
Enumeration Date:2005-06-28
Last Update Date:2011-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO0001490213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLT95183Medicare UPIN
FL87828Medicare ID - Type Unspecified