Provider Demographics
NPI:1013710128
Name:STALL, THOMAS NEWTON JR (MD)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:NEWTON
Last Name:STALL
Suffix:JR
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 SPINNAKER LN
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70124-1651
Mailing Address - Country:US
Mailing Address - Phone:928-308-5193
Mailing Address - Fax:
Practice Address - Street 1:131 S ROBERTSON ST STE 1520
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70112-2807
Practice Address - Country:US
Practice Address - Phone:504-988-5464
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-01
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program