Individual
DR. BYRON SHANE TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
452 W BANKHEAD ST, NEW ALBANY, MS 38652-3319
(662) 534-3724
(662) 534-7266
Mailing address
PO BOX 405827, ATLANTA, GA 30384-5827
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
10748
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0010261
—
MS
Enumeration date
07/14/2006
Last updated
10/25/2016
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