Provider Demographics
NPI:1215973482
Name:CAMPBELL, ROSS M (MD)
Entity type:Individual
Prefix:
First Name:ROSS
Middle Name:M
Last Name:CAMPBELL
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Gender:M
Credentials:MD
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Mailing Address - Street 1:1180 RESURGENCE DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WATKINSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30677-7210
Mailing Address - Country:US
Mailing Address - Phone:706-543-5858
Mailing Address - Fax:706-543-2050
Practice Address - Street 1:1180 RESURGENCE DR
Practice Address - Street 2:SUITE 100
Practice Address - City:WATKINSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30677-7210
Practice Address - Country:US
Practice Address - Phone:706-543-5858
Practice Address - Fax:706-543-2050
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2016-10-20
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Provider Licenses
StateLicense IDTaxonomies
GA059380207ND0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery