Provider Demographics
NPI:1285752600
Name:STUCKY, AMY TITUS (MD)
Entity type:Individual
Prefix:DR
First Name:AMY
Middle Name:TITUS
Last Name:STUCKY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 HOSPITAL DRIVE SE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801
Mailing Address - Country:US
Mailing Address - Phone:256-880-4464
Mailing Address - Fax:
Practice Address - Street 1:1 HOSPITAL DRIVE SE
Practice Address - Street 2:SUITE 100
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801
Practice Address - Country:US
Practice Address - Phone:256-880-4464
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2008-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL21239207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051559078Medicaid
AL51546111OtherBCBS OF ALABAMA
AL51546113OtherBCBS OF ALABAMA
AL51541814OtherBCBS OF ALABAMA
ALH690OtherMEDICARE
AL009912869Medicaid
AL51540854OtherBCBS OF ALABAMA
AL1285752600Medicaid
AL009912868Medicaid
AL051559078OtherMEDICARE NUMBER
AL529500990Medicaid
AL51540854OtherBCBS OF ALABAMA
AL051559078OtherMEDICARE NUMBER