Individual
BRYAN KENT STUCKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
911 N MAIN ST, GARDEN CITY, KS 67846
(620) 276-8201
(620) 276-6468
Mailing address
PO BOX 913041, DENVER, CO 80291-3041
(610) 594-5108
(610) 363-1790
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
04-34709
KS
207Q00000X
Family Medicine Physician
7243
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1518195213
NPI
—
05
—
200963170A
—
KS
Enumeration date
07/01/2009
Last updated
08/03/2018
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