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General NPI Number Information
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NPI Number | 1215081500
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Entity Type | Organization
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Legal Business Name | JEFFREY A, STICKNEY,D.O. P C
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Dates
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Enumeration Date | 01/23/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 5449 S OCCIDENTAL RD
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City | TECUMSEH
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State | MI
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Zip | 49286-9782
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Country | US
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Telephone | 517-423-3901
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Fax |
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Provider Business Mailing Address
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Address Line | 5449 S OCCIDENTAL RD
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City | TECUMSEH
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State | MI
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Zip | 49286-9782
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Country | US
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Telephone | 517-423-3901
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JEFFREY ALAN STICKNEY
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Credential | D.O.
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Telephone | 517-423-3901
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2083X0100X
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Taxonomy Name | Occupational Medicine Physician
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License Number |
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License Number State |
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