Individual
DR. FRANK CHARLES TUCKER JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
954 GRAND CANAL ST, GULF BREEZE, FL 32563-3053
(850) 934-9472
(850) 934-9472
Mailing address
954 GRAND CANAL ST, GULF BREEZE, FL 32563-3053
(850) 934-9472
(850) 934-9472
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
ME23918
FL
208200000X
Plastic Surgery Physician
23918
FL
208D00000X
General Practice Physician
Primary
23918
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
78436Z
MEDICARE PTAN
FL
01
—
ME23918
PHYSICIAN
FL
Enumeration date
06/04/2007
Last updated
01/06/2012
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