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David
C
Campbell
MD
Contract Details
Lakeside North Family Medicine
Facility name
Provider ID
P000000001
NPI
1811100985
Tax ID
863806691
Effective Date
10/6/2021
Last Updated
10/14/2021
Direct Contract
Yes
Status
Active
W9 Attachment
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
38 Rowe Drive
Guntersville, AL 35976
United States
Phone
256-571-8460
(
Phone
)
Fax
256-571-8464
Billing Details
Address
38 Rowe Drive
Guntersville, AL 35976
Billing Phone
256-571-8460
Specialty Type
Family Practice
Website
Visit Website
Workers Comp Coordinator
Nakita
Meredith
256-571-8460
nakita@lakesidenorth.org
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Address