Provider Demographics
NPI:1871276519
Name:SAMPSON, WILLIAM A
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:A
Last Name:SAMPSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:639 NORTHBRIDGE CT
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-3217
Mailing Address - Country:US
Mailing Address - Phone:317-224-3755
Mailing Address - Fax:
Practice Address - Street 1:639 NORTHBRIDGE CT
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-3217
Practice Address - Country:US
Practice Address - Phone:317-224-3755
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-09
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program