Individual
DR. STEVEN R. TUCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
800 ROSE ST STE D214A, LEXINGTON, KY 40536-6048
(270) 485-2762
Mailing address
100 SOMERSLY PL, LEXINGTON, KY 40515-5717
(270) 485-2762
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
4475
KY
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
4475
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000208416
BCBS
KY
05
—
60044757
—
KY
05
—
64044753
—
KY
05
—
65912016
—
KY
Enumeration date
10/18/2005
Last updated
04/02/2018
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