Tucker Family Medicine Psc | |
105 Greenbriar Dr Suite B Campbellsville KY 42718-9617 | |
(270) 465-0191 | |
Not Available |
Full Name | Tucker Family Medicine Psc |
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Speciality | Family Medicine |
Location | 105 Greenbriar Dr, Campbellsville, Kentucky |
Authorized Official Name and Position | Summer Tucker (FAMILY PHYSICIAN) |
Authorized Official Contact | 2704036280 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Tucker Family Medicine Psc 105 Greenbriar Dr Suite B Campbellsville KY 42718-9617 Ph: (270) 465-0191 | Tucker Family Medicine Psc 105 Greenbriar Dr Suite B Campbellsville KY 42718-9617 Ph: (270) 465-0191 |
NPI Number | 1275944589 |
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Provider Enumeration Date | 05/08/2014 |
Last Update Date | 06/24/2014 |
Medicare PECOS PAC ID | 3072737089 |
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Medicare Enrollment ID | O20140613000924 |
Identifier | Type | State | Issuer |
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1275944589 | NPI | - | NPPES |
7100230150 | Medicaid | KY |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | KY03404 (Kentucky) | Primary |
Provider Name | Summer Raye Tucker |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1659505113 PECOS PAC ID: 3779617295 Enrollment ID: I20110930000310 |
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