Healthcare Provider Details

I. General information

NPI: 1982857272
Provider Name (Legal Business Name): MR. BOB JEFFREY HAMPTON
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/30/2008
Last Update Date: 10/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31 RUBY BAY LANE
SIMPSONVILLE SC
29681
US

IV. Provider business mailing address

P.O. BOX 26511
GREENVILLE SC
29616
US

V. Phone/Fax

Practice location:
  • Phone: 864-451-2727
  • Fax:
Mailing address:
  • Phone: 864-451-2727
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225000000X
TaxonomyOrthotic Fitter
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: