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General NPI Number Information
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NPI Number | 1861420499
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Entity Type | Individual
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Provider Name | MARK W STUTZ M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/30/2006
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Last Update Date | 03/26/2015
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Provider Practice Location Address
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Address Line | 520 S 7TH ST
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City | VINCENNES
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State | IN
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Zip | 47591-1038
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Country | US
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Telephone | 812-886-6565
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Fax | 812-886-6566
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Provider Business Mailing Address
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Address Line | 520 S 7TH ST
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City | VINCENNES
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State | IN
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Zip | 47591-1038
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Country | US
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Telephone | 812-886-6565
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Fax | 812-886-6566
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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 | 207RX0202X
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Taxonomy Name | Medical Oncology Physician
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License Number | R6F02
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | R6F02
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 207RX0202X
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Taxonomy Name | Medical Oncology Physician
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License Number | 01031197A
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License Number State | IN
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