Healthcare Provider Details

I. General information

NPI: 1669008124
Provider Name (Legal Business Name): HAMPTON HASTINGS OCON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/17/2020
Last Update Date: 06/07/2024
Certification Date: 06/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

43 SMITH RD BLDG 23
NEWPORT RI
02841-1006
US

IV. Provider business mailing address

43 SMITH RD BLDG 23
NEWPORT RI
02841-1006
US

V. Phone/Fax

Practice location:
  • Phone: 401-841-2231
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number0101273036
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: