Provider Demographics
NPI:1659306546
Name:DIANA E. HAMPTON, M.D., P.C.
Entity type:Organization
Organization Name:DIANA E. HAMPTON, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:HAMPTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:405-608-8820
Mailing Address - Street 1:PO BOX 248855
Mailing Address - Street 2:DEPT.#88
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73124-8855
Mailing Address - Country:US
Mailing Address - Phone:405-608-8820
Mailing Address - Fax:405-608-8822
Practice Address - Street 1:13401 N WESTERN AVE
Practice Address - Street 2:SUITE #402
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73114-1407
Practice Address - Country:US
Practice Address - Phone:405-608-8820
Practice Address - Fax:405-608-8822
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-11
Last Update Date:2015-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK19930207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKG64937Medicare UPIN