Provider Demographics
NPI:1629968557
Name:CAMPBELL, RUDOLPH ANDREW
Entity type:Individual
Prefix:
First Name:RUDOLPH
Middle Name:ANDREW
Last Name:CAMPBELL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4357 MERCEDES ST
Mailing Address - Street 2:
Mailing Address - City:SEBRING
Mailing Address - State:FL
Mailing Address - Zip Code:33872-2750
Mailing Address - Country:US
Mailing Address - Phone:208-421-6966
Mailing Address - Fax:
Practice Address - Street 1:4357 MERCEDES ST
Practice Address - Street 2:
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33872-2750
Practice Address - Country:US
Practice Address - Phone:208-421-6966
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-03
Last Update Date:2025-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter