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Individual

ROBERT TROY STUCKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
P.A.

Contact information

Practice address
10701 NALL AVE, SUITE 200, OVERLAND PARK, KS 66211-1231
(913) 381-5225
(913) 901-0186
Mailing address
10701 NALL AVE, SUITE 200, OVERLAND PARK, KS 66211-1231
(913) 381-5225
(913) 901-0186

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
1501122
KS
363AS0400X
Surgical Physician Assistant
2006001741
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
P00401009
MEDICARE-RR
MO
01
P00416360
MEDICARE-RR
KS
Enumeration date
02/02/2006
Last updated
12/20/2007
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