Provider Demographics
NPI:1144290982
Name:CAMPBELL, JAMES MICHAEL (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:MICHAEL
Last Name:CAMPBELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4601 WHITESBURG DR S
Mailing Address - Street 2:SUITE 201
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35802-1676
Mailing Address - Country:US
Mailing Address - Phone:256-880-1050
Mailing Address - Fax:
Practice Address - Street 1:4601 WHITESBURG DR S
Practice Address - Street 2:SUITE 201
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35802-1676
Practice Address - Country:US
Practice Address - Phone:256-880-1050
Practice Address - Fax:256-880-7477
Is Sole Proprietor?:No
Enumeration Date:2006-01-24
Last Update Date:2009-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL12076207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051545597OtherBCBS AL
AL510I060016Medicare PIN
C69996Medicare UPIN