Individual
ELIZABETH FARMER STUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
213 N HURSTBOURNE PKWY, LOUISVILLE, KY 40222-5139
(502) 327-5135
(502) 327-9475
Mailing address
PO BOX 766351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
31289
KY
208000000X
Pediatrics Physician
31289
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000546083
ANTHEM
KY
01
—
000023029R
HUMANA- NORTON
KY
01
—
093039
SIHO
KY
01
—
200909250
MEDICAID IN- NORTON CMA
KY
01
—
3504095000
PASSPORT ADVANTAGE- NORTON CMA HURSTBOURNE
KY
01
—
4107882
CIGNA- NORTON
KY
01
—
50018657
PASSPORT- NORTON CMA
KY
05
—
6487966100
—
KY
01
—
P00655715
RAILROAD MEDICARE- NORTON CMA
KY
Enumeration date
12/15/2005
Last updated
07/21/2016
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