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NPI Code Detail

MEDICARE: DR. WILLIAM VINCENT STUCKY MD

MEDICARE: DR. WILLIAM VINCENT STUCKY MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207X00000XOrthopaedic Surgery Physician39336NC
2207XX0005XSports Medicine (Orthopaedic Surgery) Physician39336NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1871576918
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. WILLIAM VINCENT STUCKY MD
Provider Business Mailing Address
First Line : 4601 PARK RD
Second Line : STE 300
City : CHARLOTTE
State : NC
Zip : 28209-3239
Country : US
Telephone Number : 704-323-2000
Fax Number :
Provider Business Practice Location Address
First Line : 101 DELTA PARK DR
Second Line :
City : SHELBY
State : NC
Zip : 28150-3575
Country : US
Telephone Number : 704-323-2000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/22/2005
Last Update Date : 05/12/2010

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Directions to “ DR. WILLIAM VINCENT STUCKY MD” Practice Location

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