Provider Demographics
NPI:1235236126
Name:STUCKI, JON CURTIS (MD)
Entity Type:Individual
Prefix:DR
First Name:JON
Middle Name:CURTIS
Last Name:STUCKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:US HIGHWAY 160 AND NAVAJO RT 35
Mailing Address - Street 2:HCR 6100 BOX 30
Mailing Address - City:TEEC NOS POS
Mailing Address - State:AZ
Mailing Address - Zip Code:86514
Mailing Address - Country:US
Mailing Address - Phone:928-656-5437
Mailing Address - Fax:
Practice Address - Street 1:US HIGHWAY 160 AND NAVAJO ROUTE 35
Practice Address - Street 2:
Practice Address - City:TEEC NOS POS
Practice Address - State:AZ
Practice Address - Zip Code:86514
Practice Address - Country:US
Practice Address - Phone:928-656-5437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK3061207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKMD2052Medicaid