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General NPI Number Information
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NPI Number | 1952436149
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Entity Type | Organization
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Legal Business Name | HAMPTON FAMILY PRACTICE, INC
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Dates
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Enumeration Date | 02/21/2007
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Last Update Date | 12/03/2012
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Provider Practice Location Address
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Address Line | 25 GOSS DRIVE
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City | HAMPTON
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State | GA
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Zip | 30228-2921
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Country | US
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Telephone | 770-946-4521
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1107
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City | HAMPTON
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State | GA
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Zip | 30228-2921
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Country | US
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Telephone | 770-946-4521
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | KRISTY HENSLEY
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Credential |
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Telephone | 770-946-4521
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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 | 038996
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License Number State | GA
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