Individual
DR. MARK ALAN TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
401 E HWY 19, CENTER, MO 63436
(573) 267-3318
(573) 267-3933
Mailing address
401 E. HWY 19, CENTER, MO 63436-0311
(573) 267-3318
(573) 267-3933
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
R4C62
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
241722206
—
MO
Enumeration date
08/07/2006
Last updated
03/04/2021
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