NPI 1235764234

Mack Lee Campbell

Practitioner Driver Poplar Bluff, MO

Practice location

Address: 3634 Marble Hill Rd, Poplar Bluff, MO 63901-2228
Phone: (573) 718-0971

Registered specialties

Driver Primary

Other Service Providers Taxonomy 172A00000X

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Registry record

NPI: 1235764234
Entity type: Individual
Sex (as registered): Male
NPI issued: 10 Mar 2020
Record last updated: 10 Mar 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.