Organization
TULLAHOMA PEDIATRICS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CAROLINE B TUCK (ADMINISTRATOR)
(931) 455-2674
Entity
Organization
Contact information
Practice address
1330 CEDAR LN, BLDG B SUITE 900, TULLAHOMA, TN 37388-2283
(931) 455-2674
(931) 455-7594
Mailing address
PO BOX 1327, TULLAHOMA, TN 37388-1327
(931) 455-2674
(931) 455-7594
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
2084P0804X
Child & Adolescent Psychiatry Physician
—
—
261QR1300X
Rural Health Clinic/Center
—
—
Other
Enumeration date
01/12/2006
Last updated
06/14/2022
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