Provider Demographics
NPI:1255446431
Name:STAMP, THOMAS P
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:P
Last Name:STAMP
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6248 COMMERCIAL WAY
Mailing Address - Street 2:
Mailing Address - City:WEEKI WACHEE
Mailing Address - State:FL
Mailing Address - Zip Code:34613-6329
Mailing Address - Country:US
Mailing Address - Phone:352-597-3205
Mailing Address - Fax:352-597-3204
Practice Address - Street 1:6248 COMMERCIAL WAY
Practice Address - Street 2:
Practice Address - City:WEEKI WACHEE
Practice Address - State:FL
Practice Address - Zip Code:34613-6329
Practice Address - Country:US
Practice Address - Phone:352-597-3205
Practice Address - Fax:352-597-3204
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC3401152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist