=====================================================
General NPI Number Information
=====================================================
NPI Number | 1164800900
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | TREVOR HAMPTON D.C.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/13/2015
-----------------------------------------------------
Last Update Date | 05/13/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1131 E NORTH AVE
-----------------------------------------------------
City | BELTON
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 64012-5105
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 913-486-1608
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1306 HOWARD ST
-----------------------------------------------------
City | LOUISBURG
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 66053-8167
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 913-486-1608
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | 2015013418
-----------------------------------------------------
License Number State | MO
-----------------------------------------------------