Johnathon Antonio Montrel Tucker, PA is a
Physician Assistant physician based in Charleston, South Carolina. Johnathon Antonio Montrel Tucker is licensed to practice in South Carolina (license number 5259) and his current practice location is 4 Carriage Ln Ste 200, Charleston, South Carolina. He can be reached at his office (for appointments etc.) via phone at
(843) 266-7573.
NPI number for Johnathon Antonio Montrel Tucker is 1912767674 and his current mailing address is 4 Carriage Ln Ste 200, Charleston, South Carolina. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1912767674.
Physician's Profile
| Full Name | Johnathon Antonio Montrel Tucker |
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| Gender | Male |
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| Speciality | Physician Assistant |
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| Location | 4 Carriage Ln Ste 200, Charleston, South Carolina |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1912767674
- Provider Enumeration Date: 03/20/2024
- Last Update Date: 03/20/2024
Medical Identifiers
Medical identifiers for Johnathon Antonio Montrel Tucker such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1912767674 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 5259 (South Carolina) | Secondary |
| 363A00000X | Physician Assistant | 5259 (South Carolina) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Johnathon Antonio Montrel Tucker is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Johnathon Antonio Montrel Tucker, PA
4 Carriage Ln Ste 200,
Charleston, SC 29407-6049
Ph: (843) 266-7573 | Johnathon Antonio Montrel Tucker, PA
4 Carriage Ln Ste 200,
Charleston, SC 29407-6049
Ph: (843) 266-7573 |
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