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NPI Code Detail

MEDICARE: DR. JOHN PATRICK TUCKER M.D.

MEDICARE: DR. JOHN PATRICK TUCKER 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 Physician16639AL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1457347130
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOHN PATRICK TUCKER M.D.
Provider Business Mailing Address
First Line : 406A TAYLOR ST
Second Line :
City : SCOTTSBORO
State : AL
Zip : 35768-2424
Country : US
Telephone Number : 256-574-1050
Fax Number : 256-574-1045
Provider Business Practice Location Address
First Line : 406A TAYLOR ST
Second Line :
City : SCOTTSBORO
State : AL
Zip : 35768-2424
Country : US
Telephone Number : 256-574-1050
Fax Number : 256-574-1045
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/27/2005
Last Update Date : 10/05/2007

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Directions to “ DR. JOHN PATRICK TUCKER M.D.” Practice Location

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