Individual
DR. FORREST LEE TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
101 ELM AVE SE, ADMINISTRATIVE SUITE, ROANOKE, VA 24013-2222
(540) 985-8592
(540) 985-0475
Mailing address
101 ELM AVE SE, ADMINISTRATIVE SUITE, ROANOKE, VA 24013-2222
(540) 985-8592
(540) 985-0475
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
0101035168
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6600061000
—
WV
Enumeration date
07/20/2005
Last updated
07/09/2007
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