Individual
REBECCA SUZANNA KING-TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
110 W HONEY CREEK PKWY, TERRE HAUTE, IN 47802-4114
(812) 232-2890
(317) 988-5511
Mailing address
110 W HONEY CREEK PKWY, TERRE HAUTE, IN 47802-4114
(812) 232-2890
(317) 988-5511
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
01077239A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
011003081
MEDICARE PTAN
—
01
—
171576
OREGON MEDICAL LICENSE
OR
05
—
500628245
—
OR
Enumeration date
04/10/2007
Last updated
11/02/2016
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