Healthcare Provider Details

I. General information

NPI: 1275824922
Provider Name (Legal Business Name): STEPHEN PAUL STAMPP M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/28/2011
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

141 N ROADRUNNER PKWY STE 121
LAS CRUCES NM
88011-2000
US

IV. Provider business mailing address

141 N ROADRUNNER PKWY STE 121
LAS CRUCES NM
88011-2000
US

V. Phone/Fax

Practice location:
  • Phone: 575-800-7392
  • Fax: 575-522-4932
Mailing address:
  • Phone: 575-800-7392
  • Fax: 575-222-0876

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMD2017-0782
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: