Organization
DONALD TUCKER PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD V TUCKER JR. MD (MEDICAL DOCTOR)
(931) 454-0489
Entity
Organization
Contact information
Practice address
100 WILLIAM NORTHERN BLVD, TULLAHOMA, TN 37388-4754
(931) 454-0489
(931) 454-2348
Mailing address
100 WILLIAM NORTHERN BLVD, TULLAHOMA, TN 37388
(931) 454-0489
(931) 454-2348
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD024197
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1505159
—
TN
01
—
4185013
BCBS
TN
Enumeration date
04/29/2008
Last updated
08/22/2008
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