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NPI Code Detail

MEDICARE: DR. MELISSA S TUCK-WHITE M.D.

MEDICARE: DR. MELISSA S TUCK-WHITE M.D.
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
1207Q00000XFamily Medicine PhysicianM9065TX
2207Q00000XFamily Medicine Physician10309AWY
3207Q00000XFamily Medicine PhysicianDR.0057992CO
4207Q00000XFamily Medicine Physician23624NV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1306973979
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MELISSA S TUCK-WHITE M.D.
Provider Business Mailing Address
First Line : 5050 POWDERHOUSE RD
Second Line :
City : CHEYENNE
State : WY
Zip : 82009-4800
Country : US
Telephone Number : 307-634-1311
Fax Number : 307-634-1271
Provider Business Practice Location Address
First Line : 410 S RAMPART BLVD STE 420
Second Line :
City : LAS VEGAS
State : NV
Zip : 89145-5749
Country : US
Telephone Number : 702-240-4200
Fax Number : 702-548-4253
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/28/2007
Last Update Date : 07/03/2023

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