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General NPI Number Information
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NPI Number | 1841729217
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Entity Type | Individual
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Provider Name | BRANDON STUCKY MD
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Gender | Male
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Dates
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Enumeration Date | 06/08/2017
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Last Update Date | 03/10/2025
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Provider Practice Location Address
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Address Line | 2356 MEADOWS BLVD STE 140B
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City | CASTLE ROCK
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State | CO
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Zip | 80109-8410
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Country | US
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Telephone | 303-218-7774
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Fax | 303-660-5065
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Provider Business Mailing Address
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Address Line | 2356 MEADOWS BLVD STE 140B
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City | CASTLE ROCK
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State | CO
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Zip | 80109-8410
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Country | US
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Telephone | 303-218-7774
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Fax | 303-660-5065
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 94-09263
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 04-43043
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License Number State | KS
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | DR.74669
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License Number State | CO
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