Individual
DR. CHARLES L TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
724 ARDEN LANE, SUITE 220, ROCK HILL, SC 29732
(803) 323-2020
(803) 329-7897
Mailing address
724 ARDEN LANE, SUITE 220, ROCK HILL, SC 29732
(803) 323-2020
(803) 329-7897
Taxonomy
Speciality
Code
Description
License number
State
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
28369
SC
207WX0107X
Retina Specialist (Ophthalmology) Physician
51916
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1861433013
RAILROAD MEDICARE
—
05
—
283696
—
SC
05
—
5903003
—
NC
Enumeration date
01/25/2006
Last updated
09/06/2022
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