Individual
MR. MICHAEL NED TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
6040 N 43RD AVE STE 1, GLENDALE, AZ 85301-5481
(623) 931-2221
(623) 934-2849
Mailing address
3815 E BELL RD STE 4500, PHOENIX, AZ 85032-2171
(602) 633-3848
(602) 633-3841
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
2290
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
090146
—
AZ
Enumeration date
05/16/2006
Last updated
08/01/2024
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