Tucker, Elliot Moore

Tucker, Elliot Moore is an individual health care provider with primary practice located at 601 Childrens Ln , Norfolk VA 23507-1910. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Cardiology, which is considered as his primary health care specialty. Tucker, Elliot Moore can be contacted via phone (757) 668-7213.

Contact Information

Primary practice address
601 Childrens Ln Norfolk VA 23507-1910
Phone: (757) 668-7213
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Cardiology 2080P0202X 0101234827 Virginia

Profile Details

NPI number 1265639306
LBN Legal business name Tucker, Elliot Moore
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 2nd, 2007
Last updated Dec 19th, 2012 - about 14 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 1265639306 NPPES
Mississippi MEDICAID 02032548
Mississippi MEDICAID 1265639306
Mississippi MEDICAID 1193186
Mississippi MEDICAID 89066JW

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