Healthcare Provider Details

I. General information

NPI: 1932245743
Provider Name (Legal Business Name): BERT A HAMPTON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/29/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 W CLINCH AVE
KNOXVILLE TN
37916-2307
US

IV. Provider business mailing address

101 MEDICAL HEIGHTS DR SUITE O
FRANKFORT KY
40601-4137
US

V. Phone/Fax

Practice location:
  • Phone: 865-481-8044
  • Fax: 865-690-2774
Mailing address:
  • Phone: 865-481-8044
  • Fax: 865-690-2774

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License NumberMD9641
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: