Individual
DR. BRADEN TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1034 N 500 W, PROVO, UT 84604-3380
(801) 357-7850
Mailing address
551 DUTCH RIDGE CT, MIDWAY, UT 84049-6979
(760) 703-1017
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
12659892-1205
UT
207P00000X
Emergency Medicine Physician
64749
AZ
Other
Enumeration date
04/02/2019
Last updated
06/01/2023
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