Basic Information
| Provider Information | |||||||||
| NPI: | 1952583817 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CAMPBELL | ||||||||
| FirstName: | GARLON | ||||||||
| MiddleName: | L | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 534 N 35TH ST | ||||||||
| Address2: | SUITE A | ||||||||
| City: | MOREHEAD CITY | ||||||||
| State: | NC | ||||||||
| PostalCode: | 285573182 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2527730614 | ||||||||
| FaxNumber: | 2527720617 | ||||||||
| Practice Location | |||||||||
| Address1: | 534 N 35TH ST | ||||||||
| Address2: | SUITE A | ||||||||
| City: | MOREHEAD CITY | ||||||||
| State: | NC | ||||||||
| PostalCode: | 285573182 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2527730614 | ||||||||
| FaxNumber: | 2527720617 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/03/2007 | ||||||||
| LastUpdateDate: | 06/01/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/01/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 200701463 | NC | N | Allopathic & Osteopathic Physicians | Anesthesiology | 207LA0401X | 2007-01463 | NC | N | Allopathic & Osteopathic Physicians | Anesthesiology | Addiction Medicine | 208VP0014X | 200701463 | NC | N | Allopathic & Osteopathic Physicians | Pain Medicine | Interventional Pain Medicine | 207LP2900X | 2007-01463 | NC | Y | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine |
ID Information
| ID | Type | State | Issuer | Description | 5919028 | 05 | NC | MEDICAID |