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Individual

DR. GORDON TUCKER RISK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
8340 MISSION RD, SUITE 210, PRAIRIE VILLAGE, KS 66206-1362
(913) 642-0100
(913) 642-0176
Mailing address
8340 MISSION RD, SUITE 210, PRAIRIE VILLAGE, KS 66206-1355
(913) 642-0100
(913) 642-0176

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
04-17341
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10842510
CAQH
Enumeration date
10/16/2006
Last updated
07/13/2011
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