Dr Keiran Keith Tuck, MD | |
1040 Nw 22nd Ave, Suite 420, Portland, OR 97210-3057 | |
(503) 963-3100 | |
(503) 459-5398 |
Full Name | Dr Keiran Keith Tuck |
---|---|
Gender | Male |
Speciality | Psychiatry & Neurology - Neurology |
Location | 1040 Nw 22nd Ave, Portland, Oregon |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1578889630 | NPI | - | NPPES |
500653052 | Medicaid | OR |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084N0400X | Psychiatry & Neurology - Neurology | MD167719 (Oregon) | Primary |
Entity Name | Legacy Clinics Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1902827272 PECOS PAC ID: 0244144004 Enrollment ID: O20031117000089 |
Mailing Address | Practice Location Address |
---|---|
Dr Keiran Keith Tuck, MD Po Box 3777, Portland, OR 97208-3777 Ph: (503) 413-3900 | Dr Keiran Keith Tuck, MD 1040 Nw 22nd Ave, Suite 420, Portland, OR 97210-3057 Ph: (503) 963-3100 |
Mikel Matto, M.D. Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 2214 Lloyd Ctr, Portland, OR 97232 Phone: 503-494-4222 Fax: 503-494-6143 | |
William James Hoppe, MD Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 13303 Nw Springville Rd, Portland, OR 97229 Phone: 503-910-2664 | |
Dr. Robert Gene Mealer, M.D., PH.D. Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: 3181 Sw Sam Jackson Park Rd, Portland, OR 97239 Phone: 503-494-6176 Fax: 503-494-6152 | |
Karina Rae Espana, MD Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: 3181 Sw Sam Jackson Park Rd, Portland, OR 97239 Phone: 503-494-8311 | |
Dr. David Morrison Douglas, MD Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 3710 Sw Us Veterans Hospital Rd, Portland, OR 97239 Phone: 503-721-1440 | |
Margaret S Cary, MD, MPH Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: 3181 Sw Sam Jackson Park Rd, Mail Code Dc7p, Portland, OR 97239 Phone: 503-418-5775 Fax: 503-418-5774 | |
Dr. Melissa Beth Buboltz, M.D. Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 3181 Sw Sam Jackson Park Rd, Uhn 80, Portland, OR 97239 Phone: 503-494-8311 |