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NPI Code Detail

MEDICARE: JAMES B TUCKER ATC

MEDICARE: JAMES B TUCKER ATC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialistJ3-0000048DE

General Provider Information

NPI Number : 1013967421
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMES B TUCKER ATC
Provider Business Mailing Address
First Line : 302 OUTRIGGER WAY
Second Line :
City : MIDDLETOWN
State : DE
Zip : 19709-8976
Country : US
Telephone Number : 302-378-8066
Fax Number :
Provider Business Practice Location Address
First Line : 239 OLD NORTH RD
Second Line :
City : CAMDEN
State : DE
Zip : 19934-1241
Country : US
Telephone Number : 302-222-8098
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/10/2006
Last Update Date : 07/08/2007

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Directions to “ JAMES B TUCKER ATC” Practice Location

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