Basic Information
| Provider Information | |||||||||
| NPI: | 1225226863 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HAMPTON | ||||||||
| FirstName: | DANIEL | ||||||||
| MiddleName: | W | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5640 NUTONE ST | ||||||||
| Address2: | |||||||||
| City: | FITCHBURG | ||||||||
| State: | WI | ||||||||
| PostalCode: | 537111678 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6305673379 | ||||||||
| FaxNumber: | 6084677769 | ||||||||
| Practice Location | |||||||||
| Address1: | 601 S CENTER AVE | ||||||||
| Address2: | |||||||||
| City: | MERRILL | ||||||||
| State: | WI | ||||||||
| PostalCode: | 544523404 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7155365511 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/09/2007 | ||||||||
| LastUpdateDate: | 12/29/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/29/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 036118969 | IL | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207P00000X | 51777-21 | WI | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
ID Information
| ID | Type | State | Issuer | Description | 1225226863 | 05 | WI | MEDICAID | 036118969 | 01 | IL | STATE LICENSE NUMBER | OTHER | HANPTDAN | 01 | WI | MERCYCARE INSURANCE | OTHER | P00444352/CK6882 | 01 | IL | RAILROAD MEDICARE | OTHER | 504945390 1 | 05 | IL | MEDICAID | P00978294DB7792 | 01 | WI | RR MEDICARE | OTHER | 4673170001 | 01 | IL | DMERC | OTHER |