Individual
JASON JOHN STAMPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
19485 OLD JETTON RD STE 210, CORNELIUS, NC 28031-6592
(704) 316-1830
(704) 316-1835
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
103433
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00021556
RAILROAD MEDICARE
—
Enumeration date
07/14/2005
Last updated
11/02/2020
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