Provider Demographics
NPI:1902872351
Name:CAMPBELL, CHRISTOPHER DARRELL (M D)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:DARRELL
Last Name:CAMPBELL
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 HOSPITAL AVE
Mailing Address - Street 2:SUITE 7
Mailing Address - City:JEFFERSON
Mailing Address - State:NC
Mailing Address - Zip Code:28640-9244
Mailing Address - Country:US
Mailing Address - Phone:336-846-7238
Mailing Address - Fax:336-846-2117
Practice Address - Street 1:200 HOSPITAL AVE
Practice Address - Street 2:SUITE 7
Practice Address - City:JEFFERSON
Practice Address - State:NC
Practice Address - Zip Code:28640-9244
Practice Address - Country:US
Practice Address - Phone:336-846-7238
Practice Address - Fax:336-846-2117
Is Sole Proprietor?:No
Enumeration Date:2006-02-27
Last Update Date:2012-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC38024207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8920933Medicaid
NC2153681CMedicare ID - Type UnspecifiedMEDICARE
NC8920933Medicaid