MEDICARE: THOMAS S. 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
1	207R00000X	Internal Medicine Physician	13801	GA

General Provider Information

NPI Number	:	1932182169
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THOMAS S. TUCKER M.D.

Provider Business Mailing Address
First Line	:	755 MOUNT VERNON HWY
Second Line	:	SUITE 500
City	:	ATLANTA
State	:	GA
Zip	:	30328-4274
Country	:	US
Telephone Number	:	678-222-3145
Fax Number	:

Provider Business Practice Location Address
First Line	:	755 MOUNT VERNON HWY
Second Line	:	SUITE 500
City	:	ATLANTA
State	:	GA
Zip	:	30328-4274
Country	:	US
Telephone Number	:	678-222-3145
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/22/2005
Last Update Date	:	04/08/2014

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Directions to “ THOMAS S. TUCKER M.D.” Practice Location

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