Individual
MR. CLAIBORNE TUCKER PERDUE III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP-C
Contact information
Practice address
1326 ALVERSER PLZ, MIDLOTHIAN, VA 23113-2604
(804) 302-5212
(804) 464-1293
Mailing address
1326 ALVERSER PLZ, MIDLOTHIAN, VA 23113-2604
(804) 302-5212
(804) 464-1293
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
0024175245
VA
363LF0000X
Family Nurse Practitioner
Primary
0024175245
VA
Other
Enumeration date
08/08/2017
Last updated
01/06/2025
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