Individual
WADE TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1420 S 28TH AVE, HATTIESBURG, MS 39402-3107
(601) 264-3937
(601) 264-5930
Mailing address
1420 S 28TH AVE, HATTIESBURG, MS 39402-3107
(601) 705-0447
(601) 264-5930
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
28845
MS
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/13/2017
Last updated
07/09/2021
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