Healthcare Provider Details

I. General information

NPI: 1700327632
Provider Name (Legal Business Name): SARAH STAMPER D.O
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/11/2017
Last Update Date: 06/23/2020
Certification Date: 06/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

417 W 3RD AVE
ALBANY GA
31701-1943
US

IV. Provider business mailing address

417 W 3RD AVE
ALBANY GA
31701-1943
US

V. Phone/Fax

Practice location:
  • Phone: 229-312-1000
  • Fax: 561-472-2525
Mailing address:
  • Phone: 229-312-1000
  • Fax: 561-472-2525

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number85662
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: