Provider Demographics
NPI:1285639930
Name:HAMPTON, KARA S (OD)
Entity Type:Individual
Prefix:
First Name:KARA
Middle Name:S
Last Name:HAMPTON
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 N MAIN ST
Mailing Address - Street 2:STE 300
Mailing Address - City:SPRINGBORO
Mailing Address - State:OH
Mailing Address - Zip Code:45066-9171
Mailing Address - Country:US
Mailing Address - Phone:937-748-2955
Mailing Address - Fax:937-748-3193
Practice Address - Street 1:245 N MAIN ST
Practice Address - Street 2:STE 300
Practice Address - City:SPRINGBORO
Practice Address - State:OH
Practice Address - Zip Code:45066-9171
Practice Address - Country:US
Practice Address - Phone:937-748-2955
Practice Address - Fax:937-748-3193
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-18
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4679152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH9348121OtherGROUP MEDICARE PIN
OH4094500001Medicare NSC
OH9348121OtherGROUP MEDICARE PIN
OHU63569Medicare UPIN