Provider Demographics
NPI:1356787378
Name:STUCKEY, NATHAN JULIAN (MD)
Entity type:Individual
Prefix:
First Name:NATHAN
Middle Name:JULIAN
Last Name:STUCKEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1575 MONTGOMERY HWY
Mailing Address - Street 2:
Mailing Address - City:VESTAVIA HILLS
Mailing Address - State:AL
Mailing Address - Zip Code:35216-4510
Mailing Address - Country:US
Mailing Address - Phone:205-822-1150
Mailing Address - Fax:205-822-1158
Practice Address - Street 1:1575 MONTGOMERY HWY
Practice Address - Street 2:
Practice Address - City:VESTAVIA HILLS
Practice Address - State:AL
Practice Address - Zip Code:35216-4510
Practice Address - Country:US
Practice Address - Phone:205-822-1150
Practice Address - Fax:205-822-1158
Is Sole Proprietor?:No
Enumeration Date:2013-05-16
Last Update Date:2021-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALMD.35378207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine