Tucker, David R

Tucker, David R is an individual health care provider with primary practice located at 1721 S Stephenson Ave , Iron Mountain MI 49801-3637. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Tucker, David R can be contacted via phone (906) 774-1313.

Contact Information

Primary practice address
1721 S Stephenson Ave Iron Mountain MI 49801-3637
Phone: (906) 774-1313
Fax: (906) 776-5639
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 5601002228 Michigan

Profile Details

NPI number 1194709659
LBN Legal business name Tucker, David R
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 30th, 2005
Last updated Jul 9th, 2007 - about 19 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1194709659 NPPES
Wisconsin MEDICAID 41957100

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