Provider Demographics
NPI:1124284294
Name:CAMPBELL, BROOK ASHLEY (DO)
Entity type:Individual
Prefix:DR
First Name:BROOK
Middle Name:ASHLEY
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:MS
Other - First Name:BROOK
Other - Middle Name:ASHLEY
Other - Last Name:SANDERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1425 NORTHWEST BLUE PARKWAY
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64086
Mailing Address - Country:US
Mailing Address - Phone:816-524-5600
Mailing Address - Fax:
Practice Address - Street 1:1425 NORTHWEST BLUE PARKWAY
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64086
Practice Address - Country:US
Practice Address - Phone:816-524-5600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-29
Last Update Date:2012-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS94-07052208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics