Individual
VIVIEN O TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
13859 GREENRIDGE RD, FAYETTEVILLE, AR 72701-0789
(812) 455-8405
(479) 269-4261
Mailing address
13859 GREENRIDGE RD, FAYETTEVILLE, AR 72701-0789
(812) 455-8405
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01039200A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100359550
—
IN
Enumeration date
05/13/2006
Last updated
05/30/2025
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