Individual
ROBERT W TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
218 QUARTERMAN STREET, WAYCROSS, GA 31501-3547
(912) 287-0301
(912) 287-1568
Mailing address
218 QUARTERMAN STREET, WAYCROSS, GA 31501-3547
(912) 287-0301
(912) 287-1568
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
002765
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100002789B
—
GA
05
—
100002789C
—
GA
Enumeration date
02/16/2006
Last updated
09/30/2009
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