Basic Information
Provider Information
NPI: 1255569653
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HAMPTON
FirstName: AARON
MiddleName: EDWARD
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 245 STATE ST SE
Address2: STE 228
City: GRAND RAPIDS
State: MI
PostalCode: 49503
CountryCode: US
TelephoneNumber: 6166858050
FaxNumber: 6166851850
Practice Location
Address1: 200 JEFFERSON SE
Address2: STE 626
City: GRAND RAPIDS
State: MI
PostalCode: 49503
CountryCode: US
TelephoneNumber: 6166855039
FaxNumber: 6166858910
Other Information
ProviderEnumerationDate: 06/24/2009
LastUpdateDate: 12/17/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 12/17/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X4301094640MIY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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