Individual
DAVID JOSEPH TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1110 HIGHLANDS PLAZA DR E, STE 280, SAINT LOUIS, MO 63110-1350
(314) 273-0195
(314) 273-0190
Mailing address
670 MASON RIDGE CENTER DR, STE. 300, SAINT LOUIS, MO 63141-8573
(314) 273-0195
(314) 273-0190
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
R7D56
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110229356
RR MEDICARE
MO
01
—
P00637979
RR MEDICARE
MO
Enumeration date
09/09/2006
Last updated
09/29/2016
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