Provider Demographics
NPI:1912743238
Name:CAMPBELL, THOMAS EUGENE
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:EUGENE
Last Name:CAMPBELL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:605 S CLINTON ST APT 8A
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80247-1576
Mailing Address - Country:US
Mailing Address - Phone:720-377-6018
Mailing Address - Fax:
Practice Address - Street 1:605 S CLINTON ST APT 8A
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80247-1576
Practice Address - Country:US
Practice Address - Phone:720-377-6018
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-05
Last Update Date:2024-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171WH0202XOther Service ProvidersContractorHome Modifications