Provider Demographics
NPI:1912981614
Name:HAMPTON, WILLIAM A JR (APRN, BC)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:A
Last Name:HAMPTON
Suffix:JR
Gender:M
Credentials:APRN, BC
Other - Prefix:
Other - First Name:BILL
Other - Middle Name:A
Other - Last Name:HAMPTON
Other - Suffix:JR
Other - Last Name Type:Professional Name
Other - Credentials:APRN, BC
Mailing Address - Street 1:PO BOX 4024
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65808-4024
Mailing Address - Country:US
Mailing Address - Phone:417-885-3888
Mailing Address - Fax:417-881-7638
Practice Address - Street 1:3801 S NATIONAL AVE
Practice Address - Street 2:WEST TOWER, SUITE 700
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65807-5210
Practice Address - Country:US
Practice Address - Phone:417-885-3888
Practice Address - Fax:417-881-7638
Is Sole Proprietor?:No
Enumeration Date:2005-12-06
Last Update Date:2021-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71001993A363L00000X
MO2006035288363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO2564115OtherCOXHEALTH PLANS
MO0602002OtherUNITED HEALTH CARE
MOQ50718OtherUSPS (W/C)
MO119340OtherBLUECROSS/CHOICE
MO502277007Medicaid
INQ50718Medicare UPIN
MO832744258Medicare PIN
IN061570GGGMedicare PIN