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Individual
JASON DAVID TUCKER
Active
Individual
JASON DAVID TUCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
0101249850
VA
213ES0000X
Sports Medicine Podiatrist
Primary
01109
NC
Other
Enumeration date
07/28/2008
Last updated
11/03/2016
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