Provider Demographics
NPI:1710195516
Name:STUCKEY, JASON HUGH (MD)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:HUGH
Last Name:STUCKEY
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 1:208 MCFARLAND CIR N
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35406-1800
Mailing Address - Country:US
Mailing Address - Phone:205-343-0931
Mailing Address - Fax:205-758-3906
Practice Address - Street 1:208 MCFARLAND CIR N
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35406-1800
Practice Address - Country:US
Practice Address - Phone:205-343-0931
Practice Address - Fax:205-758-3906
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2022-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL280132085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL28013OtherMEDICAL LICENSE
AL631247115OtherAETNA
ALP01110970OtherRRMC
AL135172Medicaid
AL511-22579OtherBLUE CROSS
AL511-22566OtherBLUE CROSS
AL28013OtherMEDICAL LICENSE