Healthcare Provider Details

I. General information

NPI: 1609872217
Provider Name (Legal Business Name): SARAH WALKER HAMPTON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2005
Last Update Date: 12/05/2007
Certification Date:
Deactivation Date: 03/17/2006
Reactivation Date: 03/23/2006

III. Provider practice location address

804 N WILEY AVE
DONALSONVILLE GA
39845-1120
US

IV. Provider business mailing address

804 N WILEY AVE
DONALSONVILLE GA
39845-1120
US

V. Phone/Fax

Practice location:
  • Phone: 229-524-2706
  • Fax: 229-524-2738
Mailing address:
  • Phone: 229-524-2706
  • Fax: 229-524-2738

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number33591
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: