Tucker, Robert W

Tucker, Robert W is an individual health care provider with primary practice located at 218 Quarterman Street , Waycross GA 31501-3547. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Tucker, Robert W can be contacted via phone (912) 287-0301.

Contact Information

Primary practice address
218 Quarterman Street Waycross GA 31501-3547
Phone: (912) 287-0301
Fax: (912) 287-1568
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 002765 Georgia

Profile Details

NPI number 1710951595
LBN Legal business name Tucker, Robert W
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 16th, 2006
Last updated Sep 30th, 2009 - about 17 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 1710951595 NPPES
Georgia MEDICAID 100002789B
Georgia MEDICAID 100002789C

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