Individual
ROLAND STUCKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7333 W JEFFERSON BLVD, FORT WAYNE, IN 46804-6280
(260) 458-3830
(260) 458-3831
Mailing address
6920 POINTE INVERNESS WAY STE 200, FORT WAYNE, IN 46804-7934
(260) 479-3516
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
O1040109A
IN
Other
Enumeration date
06/14/2006
Last updated
11/02/2021
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