Jacob Dale Campbell, D.O.
Surgery, Pediatric Surgery in Farmington, CT. Individual provider (NPI-1).
NPI number1811301377
StatusActive
Last updated in NPPESNov 20, 2023
Details
- NPI
- 1811301377
- Entity type
- Individual (NPI-1)
- Name
- Jacob Dale Campbell
- Credential
- D.O.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jun 12, 2014
- Certification date
- Nov 20, 2023
- Last updated
- Nov 20, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2086S0120X | Surgery, Pediatric Surgery | 75461 | CT | Yes |
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – |
Practice location
Uconn School Of Medicine Dept Of Surgery263 Farmington Ave
Farmington, CT 06030-3955
Phone 860-679-2147 · Fax 860-679-4624
Mailing address
Uconn School Of Medicine Dept Of Surgery263 Farmington Ave
Farmington, CT 06030-3955
Phone 860-679-2147 · Fax 860-679-4624
Other practice locations
282 Washington St Fl 1
Hartford, CT 06106-3322
Hartford, CT 06106-3322
Phone 860-545-9520
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