Tucker, Juan L

Tucker, Juan L is an sole proprietor health care provider with primary practice located at 6051 U S Highway 49 , Hattiesburg MS 39401-7200. He recently has only one registered license in Technologists, Technicians & Other Technical Service Providers / Perfusionist, which is considered as his primary health care specialty. Tucker, Juan L can be contacted via phone (601) 288-4243.

Contact Information

Primary practice address
6051 U S Highway 49 Hattiesburg MS 39401-7200
Phone: (601) 288-4243
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Technologists, Technicians & Other Technical Service Providers / Perfusionist 242T00000X

Profile Details

NPI number 1881329225
LBN Legal business name Tucker, Juan L
Credentials Certified Clinical Perfusionist (CCP)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 20th, 2022
Last updated Jul 20th, 2022 - about 4 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 1881329225 NPPES
Mississippi MEDICAID 242T00000X

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