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Individual

SUMMER RAYE TUCKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.O.

Contact information

Practice address
410 HOTCHKISS ST, CAMPBELLSVILLE, KY 42718-1340
(270) 465-0191
(270) 465-0463
Mailing address
410 HOTCHKISS ST, CAMPBELLSVILLE, KY 42718-1340
(270) 465-0191
(270) 465-0463

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
02005817A
IN
207Q00000X
Family Medicine Physician
Primary
03404
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2008016205
STATE OF MISSOURI LISCENSE
MO
01
KY03404
KY BOARD OF MEDICINE
KY
Enumeration date
05/12/2009
Last updated
02/19/2024
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