Provider Demographics
NPI:1164030409
Name:CAMPBELL, MARKEITH J
Entity type:Individual
Prefix:
First Name:MARKEITH
Middle Name:J
Last Name:CAMPBELL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1327 WATERFORD POINTE CIR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43228-9108
Mailing Address - Country:US
Mailing Address - Phone:614-402-5909
Mailing Address - Fax:
Practice Address - Street 1:1327 WATERFORD POINTE CIR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43228-9108
Practice Address - Country:US
Practice Address - Phone:614-402-5909
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-22
Last Update Date:2025-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
374U00000X, 2279P4000X, 374U00000X
OHRT478706343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No2279P4000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredPatient Transport