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Individual

JAMES EDWIN TUCKER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
6500 HOSPITAL DR, HANNIBAL, MO 63401
(573) 629-3440
(573) 629-3423
Mailing address
PO BOX 1239, HANNIBAL, MO 63401-1239
(573) 629-3440
(573) 629-3423

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
2015017297
MO
207Q00000X
Family Medicine Physician
Primary
2016033286
MO

Other

Enumeration date
06/11/2015
Last updated
07/03/2018
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