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General NPI Number Information
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NPI Number | 1013219278
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Entity Type | Individual
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Provider Name | KYLE NATHAN HAMPTON D.O.
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Gender | Male
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Dates
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Enumeration Date | 11/21/2010
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Last Update Date | 07/19/2016
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Provider Practice Location Address
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Address Line | 1830 LAPORTE AVE
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City | FORT COLLINS
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State | CO
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Zip | 80521-2341
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Country | US
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Telephone | 970-416-6240
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Fax | 970-416-6241
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Provider Business Mailing Address
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Address Line | 203 S ROLLIE AVE BILLING DEPT - CREDENTIALIST
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City | FORT LUPTON
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State | CO
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Zip | 80621-1508
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Country | US
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Telephone | 303-286-4560
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Fax | 303-286-4589
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 20A11445
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS11654
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | DR.0056040
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License Number State | CO
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