Individual
MS. ALISON ANN TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3991 DUTCHMANS LN STE 205, LOUISVILLE, KY 40207-4723
(502) 899-6170
(502) 899-6179
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
45031
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000776656
ANTHEM - NCMA DORSEY
KY
01
—
000000787165
ANTHEM - NICC
KY
01
—
138745
SIHO - NCMA - DORSEY
KY
01
—
139442
SIHO - NICC
KY
Enumeration date
03/25/2009
Last updated
01/22/2021
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