Active NPI
Randall Stuckey, DPH
- Pharmacist
- Mustang, OK
National Provider Identifier
1245703321
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 12048
- Practice address
- 106 W Hwy 152
Mustang, OK 73064 - Phone
- (405) 376-3340
- Fax
- (405) 376-1390
- NPI assigned
- Jan 10, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 12048 | OK | Primary |
Addresses
Primary practice location
106 W Hwy 152
Mustang, OK 73064
Mailing address
1404 Continental Way
Mustang, OK 73064-2074
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12048 | OK | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1547078400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1547078400000",
"number": "1245703321",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1404 CONTINENTAL WAY",
"city": "MUSTANG",
"state": "OK",
"postal_code": "730642074"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "106 W HWY 152",
"city": "MUSTANG",
"state": "OK",
"postal_code": "73064",
"telephone_number": "405-376-3340",
"fax_number": "405-376-1390"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STUCKEY",
"first_name": "RANDALL",
"name_prefix": "Dr.",
"credential": "DPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-01-10",
"last_updated": "2019-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OK",
"license": "12048",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mustang, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.