Individual
JOSHUA THOMAS TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3909 S HIGHWAY 14, GREENVILLE, SC 29615-6138
(864) 522-1320
(864) 522-1325
Mailing address
1 INDEPENDENCE PT, SUITE 212, GREENVILLE, SC 29615-4545
(864) 797-6044
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2580
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2697PA
—
SC
Enumeration date
07/26/2016
Last updated
09/27/2016
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