Provider Demographics
NPI:1659493088
Name:HAMPTON, MICHAEL (BS, NCAC I,)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:HAMPTON
Suffix:
Gender:M
Credentials:BS, NCAC I,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:357 E PARKS HWY
Mailing Address - Street 2:
Mailing Address - City:WASILLA
Mailing Address - State:AK
Mailing Address - Zip Code:99654-7040
Mailing Address - Country:US
Mailing Address - Phone:907-357-5627
Mailing Address - Fax:907-957-5628
Practice Address - Street 1:357 E PARKS HWY
Practice Address - Street 2:
Practice Address - City:WASILLA
Practice Address - State:AK
Practice Address - Zip Code:99654-7040
Practice Address - Country:US
Practice Address - Phone:907-357-5627
Practice Address - Fax:907-357-5628
Is Sole Proprietor?:No
Enumeration Date:2007-04-05
Last Update Date:2010-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator