Provider Demographics
NPI:1871588210
Name:HAMPTON, GEORGE ROBERT (MD)
Entity type:Individual
Prefix:
First Name:GEORGE
Middle Name:ROBERT
Last Name:HAMPTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3107 E GENESEE ST
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13224-1646
Mailing Address - Country:US
Mailing Address - Phone:315-445-8166
Mailing Address - Fax:315-445-2697
Practice Address - Street 1:3107 E GENESEE ST
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13224-1646
Practice Address - Country:US
Practice Address - Phone:315-445-8166
Practice Address - Fax:315-445-2697
Is Sole Proprietor?:No
Enumeration Date:2005-09-13
Last Update Date:2017-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY143718207W00000X, 207WX0107X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00678368Medicaid
NY00678368Medicaid
NYB81102Medicare UPIN