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NPI Code Detail

MEDICARE: DR. ROCHELLE TUCKER MD

MEDICARE: DR. ROCHELLE TUCKER 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
12084P0800XPsychiatry PhysicianMD23932OR

General Provider Information

NPI Number : 1750375614
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ROCHELLE TUCKER MD
Provider Business Mailing Address
First Line : 281 LACLAIR ST
Second Line :
City : COOS BAY
State : OR
Zip : 97420-2988
Country : US
Telephone Number : 541-266-6777
Fax Number : 541-888-8726
Provider Business Practice Location Address
First Line : 281 LACLAIR ST
Second Line :
City : COOS BAY
State : OR
Zip : 97420-2988
Country : US
Telephone Number : 541-266-6777
Fax Number : 541-888-8726
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/07/2005
Last Update Date : 03/31/2026

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