Provider Demographics
NPI:1972132454
Name:CAMPBELL, ADAM C JR (CRT)
Entity type:Individual
Prefix:MR
First Name:ADAM
Middle Name:C
Last Name:CAMPBELL
Suffix:JR
Gender:M
Credentials:CRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 WHITNEY AVE STE 128D
Mailing Address - Street 2:
Mailing Address - City:GRETNA
Mailing Address - State:LA
Mailing Address - Zip Code:70056-2500
Mailing Address - Country:US
Mailing Address - Phone:504-473-8158
Mailing Address - Fax:
Practice Address - Street 1:401 WHITNEY AVE STE 128D
Practice Address - Street 2:
Practice Address - City:GRETNA
Practice Address - State:LA
Practice Address - Zip Code:70056-2500
Practice Address - Country:US
Practice Address - Phone:504-473-8158
Practice Address - Fax:504-509-7883
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-06
Last Update Date:2020-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LACRT.LT34852278P1005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2278P1005XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, CertifiedPulmonary RehabilitationGroup - Single Specialty