Provider Demographics
NPI:1073501011
Name:COMPTON, ARLAND HASTY JR (MD)
Entity Type:Individual
Prefix:
First Name:ARLAND
Middle Name:HASTY
Last Name:COMPTON
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:430 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SUMTER
Mailing Address - State:SC
Mailing Address - Zip Code:29150-4233
Mailing Address - Country:US
Mailing Address - Phone:803-775-5349
Mailing Address - Fax:803-775-9782
Practice Address - Street 1:430 N MAIN ST
Practice Address - Street 2:
Practice Address - City:SUMTER
Practice Address - State:SC
Practice Address - Zip Code:29150-4233
Practice Address - Country:US
Practice Address - Phone:803-775-5349
Practice Address - Fax:803-775-9782
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-13
Last Update Date:2008-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC08030207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC570641681OtherBLUE CROSS BLUE SHEILD
SC080307Medicaid
SC570641681OtherBLUE CROSS BLUE SHEILD