Provider Demographics
NPI:1669764676
Name:HAMPTON, JERROD SCOTT (MD)
Entity type:Individual
Prefix:
First Name:JERROD
Middle Name:SCOTT
Last Name:HAMPTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1610 PICKERING DR
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72211-1614
Mailing Address - Country:US
Mailing Address - Phone:918-441-0846
Mailing Address - Fax:
Practice Address - Street 1:9601 BAPTIST HEALTH DR STE 1100
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-6333
Practice Address - Country:US
Practice Address - Phone:501-227-5240
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-09
Last Update Date:2018-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP100405742085R0202X
ARE-103772085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology