Basic Information
| Provider Information | |||||||||
| NPI: | 1255343216 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CAMPBELL | ||||||||
| FirstName: | LADD | ||||||||
| MiddleName: | MATHEW | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 979 E 3RD ST | ||||||||
| Address2: | STE C235 | ||||||||
| City: | CHATTANOOGA | ||||||||
| State: | TN | ||||||||
| PostalCode: | 374033309 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4236028400 | ||||||||
| FaxNumber: | 4236028401 | ||||||||
| Practice Location | |||||||||
| Address1: | 76 PEACHTREE RD | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | ASHEVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 288033131 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8282541969 | ||||||||
| FaxNumber: | 8287715242 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/11/2006 | ||||||||
| LastUpdateDate: | 08/31/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | DO1707 | TN | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.