Healthcare Provider Details

I. General information

NPI: 1255430732
Provider Name (Legal Business Name): THOMAS FRANKLIN STAMPER JR. CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 MORRIS STREET
CHARLESTON WV
25301
US

IV. Provider business mailing address

101 QUARTERHORSE DRIVE
SCOTT DEPOT WV
25560
US

V. Phone/Fax

Practice location:
  • Phone: 304-388-6261
  • Fax: 304-388-3604
Mailing address:
  • Phone: 304-757-6103
  • Fax: 304-388-3604

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number52415
License Number StateWV
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number70070
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: