Individual
JACK T STAPLETON
Active
Individual
JACK T STAPLETON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
25543
IA
207RI0200X
Infectious Disease Physician
Primary
25543
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
23885
WELLMARK BCBS
IA
Enumeration date
10/17/2005
Last updated
08/21/2025
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