1093914806 NPI number — DR. DONALD MACIVER CAMPBELL PSYD

Table of content: DR. DONALD MACIVER CAMPBELL PSYD (NPI 1093914806)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1093914806 NPI number — DR. DONALD MACIVER CAMPBELL PSYD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CAMPBELL
Provider First Name:
DONALD
Provider Middle Name:
MACIVER
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PSYD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1093914806
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/10/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
727 FAIRVIEW DR
Provider Second Line Business Mailing Address:
STE A
Provider Business Mailing Address City Name:
CARSON CITY
Provider Business Mailing Address State Name:
NV
Provider Business Mailing Address Postal Code:
89701-5493
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
775-684-5000
Provider Business Mailing Address Fax Number:
775-687-1181

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1665 OLD HOT SPRINGS RD
Provider Second Line Business Practice Location Address:
STE 150
Provider Business Practice Location Address City Name:
CARSON CITY
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89706-0668
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
775-687-0896
Provider Business Practice Location Address Fax Number:
775-687-5103
Provider Enumeration Date:
07/12/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101Y00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TC0700X , with the licence number: PY0664 , registered in the state of NV ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com