Provider Demographics
NPI:1427138098
Name:CAMPBELL, WALTER D (MD, MS)
Entity type:Individual
Prefix:DR
First Name:WALTER
Middle Name:D
Last Name:CAMPBELL
Suffix:
Gender:M
Credentials:MD, MS
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Mailing Address - Street 1:114 N LEHMBERG RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:MS
Mailing Address - Zip Code:39702-5554
Mailing Address - Country:US
Mailing Address - Phone:662-329-2955
Mailing Address - Fax:662-370-1236
Practice Address - Street 1:114 N LEHMBERG RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:MS
Practice Address - Zip Code:39702-5554
Practice Address - Country:US
Practice Address - Phone:662-329-2955
Practice Address - Fax:662-370-1236
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036040823208000000X
MS31731208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics