CAMPBELL MEDICAL GROUP, MD, PSC NPI 1003000803

Family Medicine in Glasgow, KY

About CAMPBELL MEDICAL GROUP, MD, PSC

Campbell Medical Group, Md, Psc is a provider in Glasgow, KY. The NPI number assigned to this provider is 1003000803. The practitioner's primary taxonomy code is Family Medicine (207Q00000X). The provider is registered as an organization and their NPI record was last updated 10 years ago. Campbell Medical Group, Md, Psc operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The provider's other name is Campbell Medical Group.

NPI	1003000803 National Provider Indentifier (NPI) The 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.
Provider Name	CAMPBELL MEDICAL GROUP, MD, PSC
Provider Location Address	303 PROFESSIONAL PARK DR GLASGOW, KY 42141 Provider location address The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Mailing Address	303 PROFESSIONAL PARK DR GLASGOW, KY 42141 Provider mailing address The mailing address of the provider being identified. This address may contain the same information as the provider location address.
NPI Entity Type	Organization Entity type code The code describing the type of health care provider that is being assigned an NPI. Codes are: 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO).
Is Sole Proprietor?	N/A
Is Organization Subpart?	No What is a subpart? Subparts are the components and separate physical locations of organization health care providers. Examples include: Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.
Other Organization Name	CAMPBELL MEDICAL GROUP Provider other organization name The alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. Codes are: 1 = former name; 2 = professional name; 3 = doing business as (d/b/ a) name; 4 = former legal business name; : 5 = other.
Other Name Type	Other Name (5)
Enumeration Date	09-05-2007 Provider enumeration date The date the provider was assigned a unique identifier (assigned an NPI)
Last Update Date	12-05-2007 Last update date The date that a record was last updated or changed.

Business Address

CAMPBELL MEDICAL GROUP, MD, PSC
303 PROFESSIONAL PARK DR
GLASGOW, KY
ZIP 42141
Phone: (270) 629-3772
Fax: (270) 629-3774
Get Directions

Mailing Address

CAMPBELL MEDICAL GROUP, MD, PSC
303 PROFESSIONAL PARK DR
GLASGOW, KY
ZIP 42141
Phone: (270) 629-3772
Fax: (270) 629-3774

Primary Taxonomy

Taxonomy Code	207Q00000X Primary Taxonomy Code The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
Classification	Family Medicine
Type	Allopathic & Osteopathic Physicians
License No.	33935
License State	KY
Taxonomy Description	Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Authorized Official

Authorized Official Name	MS. JENNIFER DALTON GIBSON RHIT Authorized official name The name of the person authorized to submit the NPI application or to officially change data for a health care provider.
Authorized Official Title	OFFICE MANAGER
Authorized Official Phone	(270) 629-3772

193400000X MULTIPLE SINGLE SPECIALTY GROUP - This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Secondary Taxonomies

The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.

No.	Taxonomy Code	Type	Classification	Specialization	License No.	State	Primary
1	207RA0000X	Allopathic & Osteopathic Physicians	Internal Medicine	Adolescent Medicine	34221	KY	No
1	Taxonomy Description: an internist who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.
2	363L00000X	Physician Assistants & Advanced Practice Nursing Providers	Nurse Practitioner		4716P	KY	No
2	Taxonomy Description: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Additional Identifiers

Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier	Type / Code	Identifier State
000000360876	OTHER (01)	KY
0922102	MEDICARE UPIN (02)	KY
64019003	MEDICAID (05)	KY
9221	MEDICARE PIN (08)	KY
0922101	MEDICARE UPIN (02)	KY
000000333249	OTHER (01)	KY
64095326	MEDICAID (05)	KY

Map Location

CAMPBELL MEDICAL GROUP, MD, PSC address is 303 PROFESSIONAL PARK DR GLASGOW, KY 42141

Other Providers at the same location

The following provider is registered at the same or nearby location.

NPI	Name / Type	Taxonomy	Address
1952546020	PSYCHIATRIC WELLNESS ASSOCIATES Organization	Nurse Practitioner (Psych/Mental Health)	303 PROFESSIONAL PARK DR GLASGOW, KY 42141 (270) 629-2120