Individual
HAMPTON TEDDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3928 LANDMARK DR, DOUGLASVILLE, GA 30135-1290
(334) 524-6589
Mailing address
3928 LANDMARK DR, DOUGLASVILLE, GA 30135-1290
(334) 524-6589
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
19117787
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2310C
UNITEDHEALTHCARE, BLUECROSSBLUESHIELD, AMBETTER, HUMANA, AETNA, WELLCARE, CIGNA,
GA
Enumeration date
09/30/2019
Last updated
09/30/2019
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