Provider Demographics
NPI:1851469670
Name:CAMPBELL, MARCUS LESLIE JR (PHARMACIST)
Entity type:Individual
Prefix:DR
First Name:MARCUS
Middle Name:LESLIE
Last Name:CAMPBELL
Suffix:JR
Gender:M
Credentials:PHARMACIST
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Mailing Address - Street 1:300 WEST HOSPITAL ROAD
Mailing Address - Street 2:EISENHOWER ARMY MEDICAL CENTER ATTENTION CREDENTIALS
Mailing Address - City:FORT GORDON
Mailing Address - State:GA
Mailing Address - Zip Code:30905-5650
Mailing Address - Country:US
Mailing Address - Phone:706-787-2720
Mailing Address - Fax:706-787-8176
Practice Address - Street 1:300 WEST HOSPITAL ROAD
Practice Address - Street 2:EISENHOWER ARMY MEDICAL CENTER ATTENTION CREDENTIALS
Practice Address - City:FORT GORDON
Practice Address - State:GA
Practice Address - Zip Code:30905-5650
Practice Address - Country:US
Practice Address - Phone:706-787-2720
Practice Address - Fax:706-787-8176
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-01
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
GA015896183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist