Provider Demographics
NPI:1396754339
Name:HADLEY, HAMPTON D (DC)
Entity type:Individual
Prefix:DR
First Name:HAMPTON
Middle Name:D
Last Name:HADLEY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1905 GUM BRANCH RD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28540-4531
Mailing Address - Country:US
Mailing Address - Phone:910-938-2332
Mailing Address - Fax:910-938-7066
Practice Address - Street 1:1905 GUM BRANCH RD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28540-4531
Practice Address - Country:US
Practice Address - Phone:910-938-2332
Practice Address - Fax:910-938-7066
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-07
Last Update Date:2014-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2926111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89-085E8Medicaid
NCU87005Medicare UPIN
NC2454219Medicare ID - Type Unspecified