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Organization
TENNESSEE VALLEY VASCULAR CONSULTANTS PC
Active
Organization
TENNESSEE VALLEY VASCULAR CONSULTANTS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FRED S STUCKY III MD (PRESIDENT)
(256) 265-7480
Entity
Organization
Contact information
Practice address
420 LOWELL DR SE, SUITE 500, HUNTSVILLE, AL 35801-3754
(256) 265-7480
(256) 265-7481
Mailing address
420 LOWELL DR SE, SUITE 500, HUNTSVILLE, AL 35801-3754
(256) 265-7480
(256) 265-7481
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
00016783
AL
2086S0129X
Vascular Surgery Physician
00017567
AL
2086S0129X
Vascular Surgery Physician
Primary
0008023
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0004070317
AETNA
—
01
—
0005683727
AETNA
—
01
—
0005999121
AETNA
—
05
—
051514734
—
AL
05
—
051514735
—
AL
05
—
051514736
—
AL
01
—
51514734JOH
BLUE CROSS BLUE SHIELD
AL
01
—
51514735STU
BLUE CROSS BLUE SHIELD
AL
01
—
51514736LOW
BLUE CROSS BLUE SHIELD
AL
01
—
P00000016
MEDICARE RAILROAD
AL
01
—
P00000017
MEDICARE RAILROAD
AL
01
—
P00000018
MEDICARE RAILROAD
AL
Enumeration date
06/30/2006
Last updated
06/06/2008
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