Organization
STEVEN R. TUCKER P.S.C.
Active
Organization
STEVEN R. TUCKER P.S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEVEN R. TUCKER D.M.D. (CEO)
(270) 926-4107
Entity
Organization
Contact information
Practice address
909 SCHERM RD, OWENSBORO, KY 42301-6048
(270) 926-4107
(270) 926-4166
Mailing address
909 SCHERM RD, OWENSBORO, KY 42301-6048
(270) 926-4107
(270) 926-4166
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
4475
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000208416
BLUECROSS
KY
05
—
60044757
—
KY
05
—
64044753
—
KY
05
—
65912016
—
KY
Enumeration date
04/16/2007
Last updated
08/22/2020
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