Campbell, Kimberly Jordan

Campbell, Kimberly Jordan is an individual health care provider with primary practice located at 607 W Main St , Grangeville ID 83530-1345. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Campbell, Kimberly Jordan can be contacted via phone (208) 983-1700.

Contact Information

Primary practice address
607 W Main St Grangeville ID 83530-1345
Phone: (208) 983-1700
Fax: (208) 983-4665
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X M11531 Idaho

Profile Details

NPI number 1861669988
LBN Legal business name Campbell, Kimberly Jordan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 8th, 2008
Last updated Dec 7th, 2023 - about 3 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 1861669988 NPPES
Other 1861669988 GROUP HEALTH
Other P00767193 GROUP HEALTH
Other 1861669988 GROUP HEALTH
MEDICAID 1861669988 GROUP HEALTH
Other 01-37459 GROUP HEALTH
MEDICAID 1861669988 GROUP HEALTH
Other 1861669988 GROUP HEALTH

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