Provider Demographics
NPI:1700965829
Name:HAMPSON, FRANK (DDS)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:
Last Name:HAMPSON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 BLOOMINGTON CV
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38305-7939
Mailing Address - Country:US
Mailing Address - Phone:731-660-3658
Mailing Address - Fax:
Practice Address - Street 1:3067 N HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38305-3411
Practice Address - Country:US
Practice Address - Phone:731-668-7916
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS35091223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNDS3509OtherLICENSE #
TN0160856OtherBCBS INDIV #
TN803388OtherUCCI ID#
TN0149768OtherCOPR BCBS#