Provider Demographics
NPI:1629368949
Name:CAMPBELL, MARCUS WILLIAM (PHARMD)
Entity type:Individual
Prefix:DR
First Name:MARCUS
Middle Name:WILLIAM
Last Name:CAMPBELL
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:714 147TH CT NE
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34212-5588
Mailing Address - Country:US
Mailing Address - Phone:217-778-9802
Mailing Address - Fax:813-844-1979
Practice Address - Street 1:TGMG SUN CITY CENTER
Practice Address - Street 2:16521 SOUTH US HWY 301
Practice Address - City:WIMAUMA
Practice Address - State:FL
Practice Address - Zip Code:33598
Practice Address - Country:US
Practice Address - Phone:813-660-6770
Practice Address - Fax:813-844-1979
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-08
Last Update Date:2019-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL450021835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy