Provider Demographics
NPI:1427435783
Name:CAMPBELL, LIANA RENEE (MD)
Entity type:Individual
Prefix:
First Name:LIANA
Middle Name:RENEE
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LIANA
Other - Middle Name:RENEE
Other - Last Name:SINGH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:878 LAKELAND DR
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39216
Mailing Address - Country:US
Mailing Address - Phone:601-984-6800
Mailing Address - Fax:604-984-6811
Practice Address - Street 1:2500 NORTH STATE STREET THE UNIVERSITY OF MISSISSIPPI
Practice Address - Street 2:MEDICAL CENTER FAMILY MEDICINE DEPARTMENT
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39216
Practice Address - Country:US
Practice Address - Phone:601-984-5826
Practice Address - Fax:601-984-6889
Is Sole Proprietor?:No
Enumeration Date:2015-05-06
Last Update Date:2015-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program