Organization
MELTON R STUCKEY
Active
Other names
Columbia Family Practice
Organization subpart
No
Provider details
NPI number
Authorized official
MELTON R STUCKEY MD (OWNER)
(803) 254-2222
Entity
Organization
Contact information
Practice address
1333 TAYLOR ST, SUITE 5-E, COLUMBIA, SC 29201-2923
(803) 256-1518
(803) 256-9719
Mailing address
PO BOX 11098, COLUMBIA, SC 29211-1098
(803) 296-7305
(803) 296-7330
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP0186
—
SC
Enumeration date
06/18/2006
Last updated
01/20/2010
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