Provider Demographics
NPI:1730524364
Name:CAMPBELL, LEAH M (DO)
Entity type:Individual
Prefix:
First Name:LEAH
Middle Name:M
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5165 IMPERIAL PKWY
Mailing Address - Street 2:
Mailing Address - City:GIRARD
Mailing Address - State:PA
Mailing Address - Zip Code:16417-9524
Mailing Address - Country:US
Mailing Address - Phone:814-774-3128
Mailing Address - Fax:814-774-0915
Practice Address - Street 1:5165 IMPERIAL PKWY
Practice Address - Street 2:
Practice Address - City:GIRARD
Practice Address - State:PA
Practice Address - Zip Code:16417-9524
Practice Address - Country:US
Practice Address - Phone:814-774-3128
Practice Address - Fax:814-774-0915
Is Sole Proprietor?:No
Enumeration Date:2013-05-09
Last Update Date:2020-06-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAOT015082207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine