Individual
DR. MATTHEW DEAN TUCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1717 S UTICA AVE STE A, TULSA, OK 74104-5346
(918) 748-7557
(918) 403-0383
Mailing address
1717 S UTICA AVE STE A, TULSA, OK 74104-5346
(918) 748-7557
(918) 403-0383
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
3498
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100119850A
—
OK
01
—
930087699
RAILROAD MEDICARE
OK
Enumeration date
11/05/2005
Last updated
07/31/2020
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