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General NPI Number Information
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NPI Number | 1710195516
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Entity Type | Individual
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Provider Name | JASON HUGH STUCKEY MD
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Gender | Male
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Dates
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Enumeration Date | 05/18/2007
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Last Update Date | 09/01/2022
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Provider Practice Location Address
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Address Line | 208 MCFARLAND CIR N
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City | TUSCALOOSA
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State | AL
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Zip | 35406-1800
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Country | US
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Telephone | 205-343-0931
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Fax | 205-758-3906
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Provider Business Mailing Address
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Address Line | 208 MCFARLAND CIR N
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City | TUSCALOOSA
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State | AL
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Zip | 35406-1800
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Country | US
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Telephone | 205-343-0931
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Fax | 205-758-3906
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 28013
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License Number State | AL
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