# DR. DAVID JOHN TUCKER

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1023076619
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 2013042315 | MO | — |
| 207Q00000X | Family Medicine Physician | R3698 | AR | Yes |

## Other

- **Enumeration date:** 05/03/2006
- **Last updated:** 10/16/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100061170A | — | OK |
| 01 | — | 100726240D | OK MEDICAID GROUP NUMBER | OK |
| 05 | — | 112423001 | — | AR |
| 05 | — | 202310207 | — | MO |
| 01 | — | 50654 | AR BCBS | AR |
| 01 | — | P00144854 | RAILROAD MEDICARE NUMBER | AR |
| 01 | — | P00894372 | OCH RR MEDICARE | AR |