Provider Demographics
NPI:1750388500
Name:HAMPTON, HEATH W (MD)
Entity type:Individual
Prefix:
First Name:HEATH
Middle Name:W
Last Name:HAMPTON
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:6175 NEWTON DR NE
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:GA
Mailing Address - Zip Code:30014-2690
Mailing Address - Country:US
Mailing Address - Phone:770-786-2201
Mailing Address - Fax:770-786-0270
Practice Address - Street 1:1301 WELLBROOK CIR NE
Practice Address - Street 2:
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30012-3873
Practice Address - Country:US
Practice Address - Phone:770-922-3023
Practice Address - Fax:404-367-6981
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2019-08-28
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Provider Licenses
StateLicense IDTaxonomies
GA052273207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAQ21318Medicare UPIN
GA50BBHQJMedicare ID - Type Unspecified