Provider Demographics
NPI:1952398869
Name:CAMPBELL, BARBARA A (DPM)
Entity type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:A
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10575 N TATUM BLVD
Mailing Address - Street 2:STE C123
Mailing Address - City:PARADISE VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85253-1070
Mailing Address - Country:US
Mailing Address - Phone:480-596-1008
Mailing Address - Fax:480-596-1191
Practice Address - Street 1:10575 N TATUM BLVD
Practice Address - Street 2:STE C123
Practice Address - City:PARADISE VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85253-1070
Practice Address - Country:US
Practice Address - Phone:480-596-1008
Practice Address - Fax:480-596-1191
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-05
Last Update Date:2008-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ292213E00000X
AZ0292213EP1101X, 213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
150962OtherACHCCS PROVIDER #
AZ292OtherARIZONA STATE LICENSE #
AZAZ0190290OtherAZBXBS PROVIDER #
6299985OtherGHI PROVIDER #
860799019OtherTRICARE PROVIDER #
480006157OtherRR MEDICARE PROVIDER #
7042138OtherAETNA PROVIDER #
P85611OtherEMPIRE BX PROVIDER #
7042138OtherAETNA PROVIDER #
480006157OtherRR MEDICARE PROVIDER #
6299985OtherGHI PROVIDER #