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NPI Code Detail

MEDICARE: LAURA TUCKER CEPEDA MD

MEDICARE: LAURA TUCKER CEPEDA MD
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
1207N00000XDermatology Physician28780AL

General Provider Information

NPI Number : 1043429392
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAURA TUCKER CEPEDA MD
Provider Business Mailing Address
First Line : 202 ROCK CREEK PKWY
Second Line :
City : FAIRHOPE
State : AL
Zip : 36532-3349
Country : US
Telephone Number : 251-928-3384
Fax Number : 251-928-3353
Provider Business Practice Location Address
First Line : 202 ROCK CREEK PKWY
Second Line :
City : FAIRHOPE
State : AL
Zip : 36532-3349
Country : US
Telephone Number : 251-928-3844
Fax Number : 251-928-3353
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/22/2007
Last Update Date : 06/28/2010

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Directions to “ LAURA TUCKER CEPEDA MD” Practice Location

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