Provider Demographics
NPI:1073575072
Name:HAMPTON, MICHAEL JOSEPH (OD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:JOSEPH
Last Name:HAMPTON
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1604 PROFESSIONAL CIR
Mailing Address - Street 2:
Mailing Address - City:YUKON
Mailing Address - State:OK
Mailing Address - Zip Code:73099-6314
Mailing Address - Country:US
Mailing Address - Phone:405-354-3624
Mailing Address - Fax:405-350-7512
Practice Address - Street 1:1604 PROFESSIONAL CIR
Practice Address - Street 2:
Practice Address - City:YUKON
Practice Address - State:OK
Practice Address - Zip Code:73099-6314
Practice Address - Country:US
Practice Address - Phone:405-354-3624
Practice Address - Fax:405-350-7512
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-05
Last Update Date:2011-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1109152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK47250OtherSPECTERA
OKOK01109OtherVISION BENEFITS OF AMERIC
OKOK1109OtherEYEMED VISION CARE
OK731276615-001OtherBLUE CROSS BLUE SHIELD
OK32911OtherDAVIS VISION
OKCE813OtherBLUELINCS
OK100743790AMedicaid
OK410034491OtherRAILROAD MEDICARE
OK370009OtherNATIONAL VISION ADMINISTR
OK100762440AMedicaid
OK1031427OtherAETNA
OK47250OtherSPECTERA
OK0182270001Medicare NSC
OK370009OtherNATIONAL VISION ADMINISTR