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General NPI Number Information
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NPI Number | 1578651089
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Entity Type | Individual
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Provider Name | ALAN K TUPPONCE M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/10/2006
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Last Update Date | 11/08/2024
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Provider Practice Location Address
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Address Line | 7864 RICHMOND TAPPAHANNOCK HWY
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City | AYLETT
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State | VA
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Zip | 23009-3056
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Country | US
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Telephone | 804-535-0145
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Fax | 602-263-1637
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Provider Business Mailing Address
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Address Line | 7864 RICHMOND TAPPAHANNOCK HWY
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City | AYLETT
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State | VA
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Zip | 23009-3056
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Country | US
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Telephone | 804-535-0145
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Fax | 602-263-1637
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 0101270925
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 21275
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License Number State | OK
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