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 1:2120 E JOHNSON AVE STE 106
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32514-6091
Mailing Address - Country:US
Mailing Address - Phone:850-494-6003
Mailing Address - Fax:850-494-9636
Practice Address - Street 1:2120 E JOHNSON AVE STE 106
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32514-6091
Practice Address - Country:US
Practice Address - Phone:850-494-6003
Practice Address - Fax:850-494-9636
Is Sole Proprietor?:No
Enumeration Date:2005-12-06
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71001993A363L00000X
MO2006035288363L00000X
FLAPRN11031463363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO2564115OtherCOXHEALTH PLANS
MO0602002OtherUNITED HEALTH CARE
MOQ50718OtherUSPS (W/C)
MO502277007Medicaid
MO119340OtherBLUECROSS/CHOICE
INQ50718Medicare UPIN
MO832744258Medicare PIN
IN061570GGGMedicare PIN