Provider Demographics
NPI:1124099320
Name:CAMPBELL, DARREN C (DC)
Entity type:Individual
Prefix:DR
First Name:DARREN
Middle Name:C
Last Name:CAMPBELL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 S 4TH AVE
Mailing Address - Street 2:SUITE 4
Mailing Address - City:ELDRIDGE
Mailing Address - State:IA
Mailing Address - Zip Code:52748-1940
Mailing Address - Country:US
Mailing Address - Phone:563-285-4803
Mailing Address - Fax:563-285-2326
Practice Address - Street 1:100 S 4TH AVE
Practice Address - Street 2:SUITE 4
Practice Address - City:ELDRIDGE
Practice Address - State:IA
Practice Address - Zip Code:52748-1940
Practice Address - Country:US
Practice Address - Phone:563-285-4803
Practice Address - Fax:563-285-2326
Is Sole Proprietor?:No
Enumeration Date:2006-01-27
Last Update Date:2012-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06603111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAI9615Medicare ID - Type UnspecifiedGROUP # I9616
IAU95160Medicare UPIN