Individual
DR. MARK W STUTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
520 S 7TH ST, VINCENNES, IN 47591-1038
(812) 886-6565
(812) 886-6566
Mailing address
520 S 7TH ST, VINCENNES, IN 47591-1038
(812) 886-6565
(812) 886-6566
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
R6F02
MO
207RX0202X
Medical Oncology Physician
Primary
01031197A
IN
207RX0202X
Medical Oncology Physician
R6F02
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200922220
—
IN
05
—
202377933
—
MO
01
—
262813100
TAX ID
IN
01
—
43-1823174
TAX IDENTIFICATION NUMBER
MO
Enumeration date
06/30/2006
Last updated
03/26/2015
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