Healthcare Provider Details

I. General information

NPI: 1013710128
Provider Name (Legal Business Name): THOMAS NEWTON STALL JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2025
Last Update Date: 04/18/2026
Certification Date: 04/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

131 S ROBERTSON ST STE 1520
NEW ORLEANS LA
70112-2807
US

IV. Provider business mailing address

169 ASHLEY AVENUE ROOM 202 MAIN HOSPITAL MSC333
CHARLESTON SC
29424-0001
US

V. Phone/Fax

Practice location:
  • Phone: 504-988-5464
  • Fax:
Mailing address:
  • Phone: 928-308-5193
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number347432
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: