Individual
CORTEZ AUTHUR TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M. D.
Contact information
Practice address
1803 E MAIN ST, HUMBOLDT, TN 38343-2921
(731) 784-1975
(731) 784-1245
Mailing address
1803 E MAIN ST, HUMBOLDT, TN 38343-2921
(731) 784-1975
(731) 784-1245
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
41806
TN
207R00000X
Internal Medicine Physician
Primary
41806
TN
208VP0000X
Pain Medicine Physician
41806
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300491
—
TN
01
—
4226226
BCBS
TN
Enumeration date
09/26/2006
Last updated
07/27/2012
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