1740623701 NPI number — DR. TUCKER AND ASSOCIATES, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740623701 NPI number — DR. TUCKER AND ASSOCIATES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DR. TUCKER AND ASSOCIATES, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1740623701
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/10/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
P.O. BOX 525
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ASHFORD
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
36312
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
334-797-5880
Provider Business Mailing Address Fax Number:
334-460-9758

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1566 A EAST ANDREWS AVENUE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OZARK
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
36360
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
334-797-5880
Provider Business Practice Location Address Fax Number:
334-460-9758
Provider Enumeration Date:
04/09/2013

Additional Information

Authorized Official

Authorized Official Last Name:
TUCKER
Authorized Official First Name:
CLAUDIA
Authorized Official Middle Name:
Authorized Official Title or Position:
VICE PRESIDENT/SECRETARY
Authorized Official Telephone Number:
334-797-5879

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  2595 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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