Individual
MALLORY PAIGE TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1401 CENTERVILLE RD STE G02, TALLAHASSEE, FL 32308-4638
(850) 431-2100
(850) 431-2199
Mailing address
1401 CENTERVILLE RD STE G02, TALLAHASSEE, FL 32308-4638
(850) 431-2100
(850) 431-2199
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA9106576
FL
Other
Enumeration date
05/03/2012
Last updated
06/14/2022
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