Healthcare Provider Details

I. General information

NPI: 1306803382
Provider Name (Legal Business Name): MICHAEL S HAMPTON O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/26/2006
Last Update Date: 09/04/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

355 LINCOLN AVE OPTICAL
EAST STROUDSBURG PA
18301-2814
US

IV. Provider business mailing address

355 LINCOLN AVE
EAST STROUDSBURG PA
18301-2814
US

V. Phone/Fax

Practice location:
  • Phone: 570-424-8728
  • Fax: 570-424-8751
Mailing address:
  • Phone: 215-672-4300
  • Fax: 217-672-9524

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOEG001421
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: