Individual
MELISSA WILSON TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3680 SANGANI BLVD, DIBERVILLE, MS 39540-8703
(228) 354-9300
(228) 354-9301
Mailing address
3680 SANGANI BLVD, DIBERVILLE, MS 39540-8703
(228) 354-9300
(228) 354-9301
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
22560
MS
Other
Enumeration date
06/06/2007
Last updated
09/17/2014
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