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General NPI Number Information
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NPI Number | 1093121782
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Entity Type | Individual
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Provider Name | MARK BAMPTON OD
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Gender | Male
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Dates
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Enumeration Date | 07/02/2014
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Last Update Date | 05/10/2022
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Provider Practice Location Address
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Address Line | 1000 ATLANTIC AVE
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City | CAMDEN
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State | NJ
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Zip | 08104-1132
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Country | US
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Telephone | 805-208-8614
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Fax |
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Provider Business Mailing Address
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Address Line | 1502 PHEASANT HOLLOW DR
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City | PLAINSBORO
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State | NJ
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Zip | 08536-3508
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Country | US
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Telephone | 805-208-8614
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Fax |
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OEG003858
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 27OA00673500
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 270A00673500
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License Number State | NJ
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