Individual
JOEL A TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1720A MEDICAL PARK DR, SUITE 220, BILOXI, MS 39532-2129
(228) 392-9355
(228) 392-1781
Mailing address
6300 E LAKE BLVD, STE. 301, VANCLEAVE, MS 39565-6770
(228) 230-2663
(228) 206-1192
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
21487
MS
207X00000X
Orthopaedic Surgery Physician
TRN9064
FL
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
Primary
21487
MS
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
ME106815
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002486000
—
FL
Enumeration date
12/13/2006
Last updated
03/22/2017
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