Individual
MRS. KEELIE RENEE TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
620 S MADISON ST, SUITE 203, ENID, OK 73701-7273
(580) 213-9760
(580) 213-9769
Mailing address
5300 N INDEPENDENCE AVE, 280, OKLAHOMA CITY, OK 73112-5556
(580) 213-9760
(580) 213-9769
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
28642
OK
207V00000X
Obstetrics & Gynecology Physician
P0146
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200345390A
—
OK
Enumeration date
09/12/2007
Last updated
02/12/2018
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