Individual
DR. SONNY WILLIE TUCKER JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
2008-00963
NC
2086S0129X
Vascular Surgery Physician
A85121
CA
2086S0129X
Vascular Surgery Physician
T0964
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5909467
—
NC
Enumeration date
05/22/2008
Last updated
07/07/2026
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