Tucker, David John
Tucker, David John is an individual health care provider with primary practice located at 1101 Jackson St Sw , Gravette AR 72736-9121. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Tucker, David John can be contacted via phone (479) 787-5221.Contact Information
Primary practice address
1101 Jackson St Sw
Gravette AR 72736-9121
Phone: (479) 787-5221
Fax: (479) 787-5613
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 2013042315 | Missouri |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | R3698 | Arkansas |
Profile Details
| NPI number | 1023076619 |
|---|---|
| LBN Legal business name | Tucker, David John |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 3rd, 2006 |
| Last updated | Oct 16th, 2023 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1023076619 | NPPES |
| Arkansas | MEDICAID | 112423001 | |
| Arkansas | Other | 50654 | |
| Arkansas | Other | 100726240D | |
| Arkansas | MEDICAID | 100061170A | |
| Arkansas | MEDICAID | 202310207 | |
| Arkansas | Other | P00144854 | |
| Arkansas | Other | P00894372 |
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