Provider Demographics
NPI:1508037599
Name:RICHARD G. STUEMPFLE
Entity Type:Organization
Organization Name:RICHARD G. STUEMPFLE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:G
Authorized Official - Last Name:STUEMPFLE
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:570-748-5527
Mailing Address - Street 1:36 E CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:LOCK HAVEN
Mailing Address - State:PA
Mailing Address - Zip Code:17745-2556
Mailing Address - Country:US
Mailing Address - Phone:570-748-5527
Mailing Address - Fax:
Practice Address - Street 1:36 E CHURCH ST
Practice Address - Street 2:
Practice Address - City:LOCK HAVEN
Practice Address - State:PA
Practice Address - Zip Code:17745-2556
Practice Address - Country:US
Practice Address - Phone:570-748-5527
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-18
Last Update Date:2008-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC-OOO444L213EP1101X
PASC-000444L335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0158900001Medicare NSC