Individual
DR. JEFFREY GLEN TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
980 SANDERS RD, SUITE 100, CUMMING, GA 30041-5977
(770) 886-1074
(770) 205-4717
Mailing address
980 SANDERS RD, SUITE 100, CUMMING, GA 30041-5977
(770) 886-1074
(770) 205-4717
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
034068
GA
208600000X
Surgery Physician
034068
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000468608K
—
GA
Enumeration date
09/09/2005
Last updated
01/11/2017
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