Provider Demographics
NPI:1255406310
Name:HAMPTON, PAUL D (OD)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:D
Last Name:HAMPTON
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:234 SHERWOOD DOWNS RD N
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:OH
Mailing Address - Zip Code:43055-3349
Mailing Address - Country:US
Mailing Address - Phone:740-364-1383
Mailing Address - Fax:
Practice Address - Street 1:2305 MAPLE AVE
Practice Address - Street 2:
Practice Address - City:ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43701-2028
Practice Address - Country:US
Practice Address - Phone:740-453-6670
Practice Address - Fax:740-453-6670
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3536152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0909324Medicaid
OH0909324Medicaid
OH0717062Medicare ID - Type Unspecified