Provider Demographics
NPI:1932698966
Name:STUCKI, JARED DANIEL (DO)
Entity Type:Individual
Prefix:DR
First Name:JARED
Middle Name:DANIEL
Last Name:STUCKI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1301 S CRISMON RD
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85209-3767
Mailing Address - Country:US
Mailing Address - Phone:480-373-2370
Mailing Address - Fax:480-373-2375
Practice Address - Street 1:1301 S CRISMON RD
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85209-3767
Practice Address - Country:US
Practice Address - Phone:480-373-2370
Practice Address - Fax:480-373-2375
Is Sole Proprietor?:No
Enumeration Date:2018-05-04
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
UT13387518-1204208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery