Provider Demographics
NPI:1740381730
Name:BAMPTON, RODNEY J (DC)
Entity Type:Individual
Prefix:DR
First Name:RODNEY
Middle Name:J
Last Name:BAMPTON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1420 W. MEYER RD.
Mailing Address - Street 2:
Mailing Address - City:WENTZVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:63385
Mailing Address - Country:US
Mailing Address - Phone:636-639-9660
Mailing Address - Fax:636-639-9135
Practice Address - Street 1:1420 W MEYER RD
Practice Address - Street 2:
Practice Address - City:WENTZVILLE
Practice Address - State:MO
Practice Address - Zip Code:63385-3499
Practice Address - Country:US
Practice Address - Phone:636-639-9660
Practice Address - Fax:636-639-9135
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2011-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2002020920111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO002282557004OtherUHC PROVIDER NUMBER
MO7867758OtherAETNA
MOP00721748OtherMEDICARE RAILROAD PTAN
MO165169OtherBLUE CROSS BLUE SHIELD MO
MO231981OtherGHP
MO002282557004OtherUHC PROVIDER NUMBER
MOP00721748OtherMEDICARE RAILROAD PTAN