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General NPI Number Information
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NPI Number | 1609905462
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Entity Type | Individual
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Provider Name | JEREMY RYAN STAPLETON DO
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Gender | Male
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Dates
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Enumeration Date | 03/05/2007
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Last Update Date | 09/30/2025
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Provider Practice Location Address
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Address Line | 3100 MACCORKLE AVE SE STE 500
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City | CHARLESTON
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State | WV
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Zip | 25304-1226
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Country | US
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Telephone | 304-342-0821
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Fax | 304-345-6679
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Provider Business Mailing Address
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Address Line | 3100 MACCORKLE AVE SE STE 500
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City | CHARLESTON
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State | WV
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Zip | 25304-1226
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Country | US
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Telephone | 304-342-0821
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Fax | 304-345-6679
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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 | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 2126
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License Number State | WV
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 03019
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 03019
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License Number State | KY
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