Provider Demographics
NPI:1548467111
Name:STAMPER, ELIZABETH AUDREY (DO)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:AUDREY
Last Name:STAMPER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:600 E 20TH ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:EUDORA
Mailing Address - State:KS
Mailing Address - Zip Code:66025-9593
Mailing Address - Country:US
Mailing Address - Phone:785-542-2345
Mailing Address - Fax:785-542-1239
Practice Address - Street 1:600 E 20TH ST
Practice Address - Street 2:SUITE 200
Practice Address - City:EUDORA
Practice Address - State:KS
Practice Address - Zip Code:66025-9593
Practice Address - Country:US
Practice Address - Phone:785-542-2345
Practice Address - Fax:785-542-1239
Is Sole Proprietor?:No
Enumeration Date:2007-06-28
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS0534780207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200685430AMedicaid
KS200685430AMedicaid