Basic Information
Provider Information
NPI: 1750887089
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: STOPPELMAN
FirstName: TIMOTHY
MiddleName: ARTHUR
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 200 HAWKINS DR
Address2:  
City: IOWA CITY
State: IA
PostalCode: 522421009
CountryCode: US
TelephoneNumber: 3193567205
FaxNumber:  
Practice Location
Address1: 2301 HOLMES ST
Address2:  
City: KANSAS CITY
State: MO
PostalCode: 641082677
CountryCode: US
TelephoneNumber: 8164044175
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/04/2018
LastUpdateDate: 03/22/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/22/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X MON Student, Health CareStudent in an Organized Health Care Education/Training Program 
207LP2900XR-12350IAY Allopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine

No ID Information.


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