Organization
GERIATRIC SPECIALISTS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL A TUCKER (PRINCIPAL)
(417) 773-6154
Entity
Organization
Contact information
Practice address
800 STATE HIGHWAY 248 BLDG III, BRANSON, MO 65616-3721
(417) 773-6154
Mailing address
PO BOX 10887, SPRINGFIELD, MO 65808-0887
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
06/14/2010
Last updated
06/14/2010
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