Healthcare Provider Details

I. General information

NPI: 1215980370
Provider Name (Legal Business Name): THOMAS SANDERS STAMPS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 05/03/2022
Certification Date: 04/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 WYOMING ST
LANDER WY
82520-3919
US

IV. Provider business mailing address

LANDER MEDICAL CLINIC, P.C. 745 BUENA VISTA DR.
LANDER WY
82520-3919
US

V. Phone/Fax

Practice location:
  • Phone: 307-332-2185
  • Fax: 307-332-7799
Mailing address:
  • Phone: 307-332-2941
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number8178A
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: