Individual
DR. TUCKER D JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
2014 EXETER RD, GERMANTOWN, TN 38138-3945
(901) 624-4600
(901) 757-1485
Mailing address
122 COVINGTON ST, PO BOX 147, STANTON, TN 38069-4428
(731) 548-6562
(731) 548-6563
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
P0000002427
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00329380
MEDICARE RAILROAD
—
Enumeration date
05/05/2006
Last updated
02/12/2008
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