Individual
ERIC D. TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAAA
Contact information
Practice address
1000 JOHNSON FERRY ROAD, ATLANTA, GA 30342
(770) 645-9181
(770) 645-8455
Mailing address
3155 N POINT PKWY, ATTN: CREDENTIALING DEPT, BUILDING F, SUITE 100, ALPHARETTA, GA 30005
(770) 645-9181
(770) 645-8455
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
2251
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100000368A
—
GA
05
—
100000368B
—
GA
05
—
100000368G
—
GA
05
—
100000368H
—
GA
05
—
100000368I
—
GA
01
—
P00353064
RAILROAD MEDICARE
—
Enumeration date
10/03/2005
Last updated
10/09/2008
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