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General NPI Number Information
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NPI Number | 1255711537
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Entity Type | Individual
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Provider Name | IAN DOUGLAS STAMPS M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/02/2015
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Last Update Date | 09/03/2024
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Provider Practice Location Address
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Address Line | 6211 WATERFORD BLVD
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City | EVANSVILLE
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State | IN
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Zip | 47715-2869
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Country | US
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Telephone | 812-465-6202
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Fax | 812-474-3621
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Provider Business Mailing Address
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Address Line | 6211 WATERFORD BLVD
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City | EVANSVILLE
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State | IN
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Zip | 47715-2869
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Country | US
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Telephone | 812-465-6202
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Fax | 812-474-3621
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | 11018259A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 01082339A
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License Number State | IN
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