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Individual
JORDAN R TUCKER
Active
Individual
JORDAN R TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
14299545-1205
UT
207Q00000X
Family Medicine Physician
14299545-8905
UT
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
177120115
DRIVERS LISENCE
UT
Enumeration date
01/17/2023
Last updated
09/16/2026
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