Individual
CHARLES HOWELL TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
340 BRANDYWINE BLVD, FAYETTEVILLE, GA 30214-1562
(770) 460-4286
(770) 460-4016
Mailing address
3225 CUMBERLAND BLVD SE, SUITE 900, ATLANTA, GA 30339-6407
(404) 351-2220
(404) 355-5624
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
027255
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000332835H
—
GA
01
—
18BDFFL
MEDICARE ID
—
Enumeration date
04/14/2006
Last updated
03/20/2019
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