# ROBERT TUCKER THOLE

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

## Provider details

- **NPI number:** 1053384107
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 9686 | NV | Yes |
| 207QS0010X | Sports Medicine (Family Medicine) Physician | 9686 | NV | — |

## Other

- **Enumeration date:** 02/09/2006
- **Last updated:** 09/06/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 002016818 | — | NV |
| 01 | — | 080173706 | RAILROAD MEDICARE | NV |
| 01 | — | 11042017 | CAQH | — |
| 01 | — | P00259419 | RR MEDICARE | NV |