Elliot Moore Tucker, MD | |
601 Childrens Ln, Norfolk, VA 23507-1910 | |
(757) 668-7213 | |
Not Available |
Full Name | Elliot Moore Tucker |
---|---|
Gender | Male |
Speciality | Pediatrics - Pediatric Cardiology |
Location | 601 Childrens Ln, Norfolk, Virginia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1265639306 | NPI | - | NPPES |
02032548 | Medicaid | MS | |
1265639306 | Medicaid | VA | |
1193186 | Medicaid | LA | |
89066JW | Medicaid | NC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2080P0202X | Pediatrics - Pediatric Cardiology | 0101234827 (Virginia) | Primary |
Entity Name | University Of Virginia Physicians Group |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1033138250 PECOS PAC ID: 4880590728 Enrollment ID: O20040102000780 |
Entity Name | Childrens Specialty Group Pllc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1255354130 PECOS PAC ID: 5890788764 Enrollment ID: O20040406001195 |
Mailing Address | Practice Location Address |
---|---|
Elliot Moore Tucker, MD 601 Childrens Ln, Norfolk, VA 23507-1910 Ph: (757) 668-7213 | Elliot Moore Tucker, MD 601 Childrens Ln, Norfolk, VA 23507-1910 Ph: (757) 668-7213 |
Joshua Wayne Gollub, Pediatrics Medicare: Medicare Enrolled Practice Location: 601 Childrens Ln, Norfolk, VA 23507 Phone: 757-668-7000 | |
Stephen C. Restaino, DO Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 601 Childrens Ln, Norfolk, VA 23507 Phone: 757-668-7179 Fax: 757-668-9810 | |
Michael Lee Smith, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 601 Childrens Ln, Norfolk, VA 23507 Phone: 757-668-7456 Fax: 757-668-9255 | |
Phyllis R. Hope, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 601 Childrens Ln, Norfolk, VA 23507 Phone: 757-668-7456 Fax: 757-668-9255 | |
Linda D Pegram, M.D. Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 601 Childrens Ln, Norfolk, VA 23507 Phone: 757-668-7007 Fax: 757-668-8658 | |
Ernette Yvonne Benson-foulk, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 6345 Center Dr, Building 14, Norfolk, VA 23502 Phone: 757-461-4027 Fax: 757-461-8821 | |
Monica G Baker, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 601 Childrens Ln, Norfolk, VA 23507 Phone: 757-668-7456 Fax: 757-668-9255 |