Provider Demographics
NPI:1477710739
Name:HAMPDEN, KEITH A (PHD)
Entity Type:Individual
Prefix:DR
First Name:KEITH
Middle Name:A
Last Name:HAMPDEN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 8TH ST NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20002-6153
Mailing Address - Country:US
Mailing Address - Phone:202-546-7696
Mailing Address - Fax:202-546-8061
Practice Address - Street 1:201 8TH ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-6153
Practice Address - Country:US
Practice Address - Phone:202-546-7696
Practice Address - Fax:202-546-8061
Is Sole Proprietor?:No
Enumeration Date:2008-05-22
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCDI100000314133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered