Basic Information
Provider Information
NPI: 1326096819
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CAMPBELL
FirstName: JOHN
MiddleName: FRANKLIN
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1200 N ELM ST
Address2:  
City: GREENSBORO
State: NC
PostalCode: 274011004
CountryCode: US
TelephoneNumber: 3368327000
FaxNumber:  
Practice Location
Address1: 301 E WENDOVER AVE
Address2: SUITE 111
City: GREENSBORO
State: NC
PostalCode: 274011230
CountryCode: US
TelephoneNumber: 3368327840
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/05/2006
LastUpdateDate: 08/26/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/26/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X32660NCN Allopathic & Osteopathic PhysiciansInternal Medicine 
207RI0200X32660NCY Allopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease

ID Information
IDTypeStateIssuerDescription
359601NCPARTNERS MEDICAREOTHER
431618001NCAETNAOTHER
2096601NCBCBSNCOTHER
7143301NCMEDCOSTOTHER
892096605NC MEDICAID


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