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General NPI Number Information
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NPI Number | 1992598338
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Entity Type | Organization
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Legal Business Name | TUCKER MEDICAL MANAGEMENT SERVICES, LLC
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Dates
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Enumeration Date | 05/28/2025
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Last Update Date | 05/28/2025
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Provider Practice Location Address
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Address Line | 2704 W OXFORD LOOP STE 117
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City | OXFORD
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State | MS
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Zip | 38655-5728
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Country | US
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Telephone | 423-603-3700
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Fax |
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Provider Business Mailing Address
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Address Line | 602 THRASHER PT
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City | OXFORD
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State | MS
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Zip | 38655-5970
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Country | US
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Telephone | 423-603-3700
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | DR. PATRICK EDWIN TUCKER
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Credential | MD
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Telephone | 662-415-7020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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