Provider Demographics
NPI:1841751872
Name:CAMPBELL, JAMES CLARK (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:CLARK
Last Name:CAMPBELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 PROFESSIONAL BLVD
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47714-8014
Mailing Address - Country:US
Mailing Address - Phone:812-473-2060
Mailing Address - Fax:
Practice Address - Street 1:1401 PROFESSIONAL BLVD
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47714-8014
Practice Address - Country:US
Practice Address - Phone:812-473-2060
Practice Address - Fax:812-473-0763
Is Sole Proprietor?:No
Enumeration Date:2019-03-31
Last Update Date:2025-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNA207Y00000X
KY60592207Y00000X
IN01095785A207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY60592OtherSTATE LICENSE
IN01095785AOtherSTATE LICENSE
NC954034696RMedicaid