Provider Demographics
NPI:1467420091
Name:HAMPTON, BRETT JEFFREY (MD)
Entity Type:Individual
Prefix:
First Name:BRETT
Middle Name:JEFFREY
Last Name:HAMPTON
Suffix:
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 1:11698 HOLLYVIEW DR
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:VA
Mailing Address - Zip Code:22066-1329
Mailing Address - Country:US
Mailing Address - Phone:434-825-1691
Mailing Address - Fax:
Practice Address - Street 1:9601 BLACKWELL RD STE 100
Practice Address - Street 2:SHADY GROVE ORTHOPAEDICS
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-6477
Practice Address - Country:US
Practice Address - Phone:301-340-9200
Practice Address - Fax:301-340-6934
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2016-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101238375207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD021910G27OtherMEDICARE
MD3148412OtherMAMSI
MD021910G27OtherMEDICARE