Healthcare Provider Details

I. General information

NPI: 1427277888
Provider Name (Legal Business Name): SPENCER PAUL TUCKER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2007
Last Update Date: 09/29/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12163 E ADAMS RD
HAMMOND LA
70403-2103
US

IV. Provider business mailing address

12163 E ADAMS RD
HAMMOND LA
70403-2103
US

V. Phone/Fax

Practice location:
  • Phone: 225-294-0532
  • Fax: 225-294-0532
Mailing address:
  • Phone: 225-294-0532
  • Fax: 225-294-0532

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD.202239
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number202239
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: