Provider Demographics
NPI:1740247600
Name:HAMPTON, WILLIAM R (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:R
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 1:111 N MAPLEMERE RD STE 120
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-3178
Mailing Address - Country:US
Mailing Address - Phone:716-836-4646
Mailing Address - Fax:716-836-4696
Practice Address - Street 1:111 N MAPLEMERE RD STE 120
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-3178
Practice Address - Country:US
Practice Address - Phone:716-836-4646
Practice Address - Fax:716-836-4696
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1810822085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
00040944102OtherUNIVERA
NY1810829BOtherNYS WORKERS COMPENSATION
NY000911452011OtherBLUE SHIELD WNY
040426003072OtherFIDELIS
1693150OtherINDEPENDENT HEALTH
101315FFOtherPREFERRED CARE
NY01420442Medicaid
4195934OtherGHI
P00005725OtherRR MEDICARE
NY000911452011OtherBLUE SHIELD WNY
040426003072OtherFIDELIS
DD6587Medicare PIN
RB2812Medicare PIN