Individual
DR. JANE L TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2315 DOUGHERTY FERRY RD, SUITE 205, SAINT LOUIS, MO 63122-3383
(314) 977-9600
(314) 977-9627
Mailing address
2315 DOUGHERTY FERRY RD, SUITE 205, SAINT LOUIS, MO 63122-3383
(314) 977-9600
(314) 977-9627
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
0101055692
VA
207Q00000X
Family Medicine Physician
Primary
2013038957
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010114438
—
VA
Enumeration date
02/22/2006
Last updated
04/19/2021
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