| Tucker Internal Medicine, Llc | |
|
4228 First Ave Ste 1 Tucker GA 30084-4426 | |
| (770) 414-5758 | |
| (770) 414-8699 |
| Full Name | Tucker Internal Medicine, Llc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 4228 First Ave, Tucker, Georgia |
| Authorized Official Name and Position | Laura E Davidson (OWNER) |
| Authorized Official Contact | 7703661229 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tucker Internal Medicine, Llc Po Box 506 Tucker GA 30085-0506 Ph: (770) 414-5758 | Tucker Internal Medicine, Llc 4228 First Ave Ste 1 Tucker GA 30084-4426 Ph: (770) 414-5758 |
| NPI Number | 1386908739 |
|---|---|
| Provider Enumeration Date | 06/30/2012 |
| Last Update Date | 06/30/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386908739 | NPI | - | NPPES |
| 000335838K | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 028960 (Georgia) | Primary |
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