Campbell, Jesse R.

Campbell, Jesse R. is an individual health care provider with primary practice located at 1575 N Santa Fe Ave , Edmond OK 73003-3638. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Campbell, Jesse R. can be contacted via phone (405) 285-0660.

Contact Information

Primary practice address
1575 N Santa Fe Ave Edmond OK 73003-3638
Phone: (405) 285-0660
Fax: (405) 285-0659
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 20229 Oklahoma

Profile Details

NPI number 1982653721
LBN Legal business name Campbell, Jesse R.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 9th, 2006
Last updated Dec 28th, 2017 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1982653721 NPPES
Oklahoma Other 20229 LICENSE
Oklahoma MEDICAID 100108140A LICENSE
Oklahoma Other 25208 LICENSE

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