Provider Demographics
NPI:1720085509
Name:STAMLER, JOHN FREDERIC (MD, PHD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:FREDERIC
Last Name:STAMLER
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2629 NORTHGATE DR
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52245-9565
Mailing Address - Country:US
Mailing Address - Phone:319-338-3623
Mailing Address - Fax:319-338-7289
Practice Address - Street 1:2629 NORTHGATE DR
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52245-9565
Practice Address - Country:US
Practice Address - Phone:319-338-3623
Practice Address - Fax:319-338-7289
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2012-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA23678207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA19965OtherBLUE CROSS BLUE SHIELD
IA42144513501OtherJOHN DEERE HEALTH
IA0116798Medicaid
IA180022818OtherRAILROAD MEDICARE
IAA02234Medicare UPIN
IA180022818OtherRAILROAD MEDICARE