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Individual

LESLIE E TUCKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
901 PATIENTS FIRST DR, WASHINGTON, MO 63090-4700
(636) 239-7344
(636) 239-9436
Mailing address
901 PATIENTS FIRST DR, WASHINGTON, MO 63090-4700
(636) 239-7344
(636) 239-9436

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
R5740
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
100013863
RAILROAD MEDICARE
05
200991511
MO
Enumeration date
06/14/2006
Last updated
01/23/2012
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