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Organization

WAYNE TUCKER DO, PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. WAYNE IRA TUCKER DO, PA (OWNER)
(302) 838-1100
Entity
Organization

Contact information

Practice address
100 BECKS WOODS DR, SUITE 202, BEAR, DE 19701-3835
(302) 838-1100
(302) 838-8962
Mailing address
101 BECKS WOODS DR, SUITE 100, BEAR, DE 19701
(302) 838-1100
(302) 838-8962

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
F1-0000484
DE
207Q00000X
Family Medicine Physician
Primary
C2004133
DE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0001131503
DE
01
0100579
UNITED HEALTHCARE
DE
01
116893
COVENTRY
DE
01
1770601874
BCBS
DE
01
4331251
AETNA
DE
Enumeration date
03/27/2007
Last updated
04/16/2014
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