Provider Demographics
NPI:1669707832
Name:LAMPTON, CHARLES C (PHD)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:C
Last Name:LAMPTON
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 1:2725 ORCHARD HILL RD
Mailing Address - Street 2:
Mailing Address - City:SILOAM SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:72761-8340
Mailing Address - Country:US
Mailing Address - Phone:479-524-7391
Mailing Address - Fax:479-524-8651
Practice Address - Street 1:2725 ORCHARD HILL RD
Practice Address - Street 2:
Practice Address - City:SILOAM SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:72761-8340
Practice Address - Country:US
Practice Address - Phone:479-524-7391
Practice Address - Fax:479-524-8651
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-06
Last Update Date:2009-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR95-6P103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5S945OtherBLUE CROSS