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Organization

TUCKER FAMILY MEDICINE PSC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SUMMER TUCKER D.O. (FAMILY PHYSICIAN)
(270) 403-6280
Entity
Organization

Contact information

Practice address
105 GREENBRIAR DR, SUITE B, CAMPBELLSVILLE, KY 42718-9617
(270) 465-0191
Mailing address
105 GREENBRIAR DR, SUITE B, CAMPBELLSVILLE, KY 42718-9617
(270) 465-0191

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
KY03404
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7100230150
KY
Enumeration date
05/08/2014
Last updated
06/24/2014
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