Provider Demographics
NPI:1306406855
Name:HAMPTON DIRECT PRIMARY CARE
Entity Type:Organization
Organization Name:HAMPTON DIRECT PRIMARY CARE
Other - Org Name:HAMPTON MEDICAL DIRECT PRIMARY CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:PHILIP
Authorized Official - Last Name:HAMPTON
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:814-215-9494
Mailing Address - Street 1:3229 PLEASANT VALLEY BLVD STE 1
Mailing Address - Street 2:
Mailing Address - City:ALTOONA
Mailing Address - State:PA
Mailing Address - Zip Code:16602-4435
Mailing Address - Country:US
Mailing Address - Phone:814-215-9494
Mailing Address - Fax:814-281-3507
Practice Address - Street 1:3229 PLEASANT VALLEY BLVD STE 1
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16602-4435
Practice Address - Country:US
Practice Address - Phone:814-215-9494
Practice Address - Fax:814-281-3507
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-17
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Single Specialty