Campbell, Matthew Warren
Campbell, Matthew Warren is an sole proprietor health care provider with primary practice located at 2005 Harris Dr , Oxford MS 38655-4222. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Campbell, Matthew Warren can be contacted via phone (662) 513-9936.Contact Information
Primary practice address
2005 Harris Dr
Oxford MS 38655-4222
Phone: (662) 513-9936
Fax: (662) 513-9937
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 43-695 | Mississippi |
Profile Details
| NPI number | 1790706398 |
|---|---|
| LBN Legal business name | Campbell, Matthew Warren |
| Credentials | PH.D. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 21st, 2006 |
| Last updated | Dec 15th, 2008 - about 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1790706398 | NPPES |
| Mississippi | MEDICAID | 08079804 |
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