Tucker Medical Group, P.c. | |
460 W 2600 S Bountiful UT 84010-7716 | |
(801) 660-8687 | |
(866) 332-8067 |
Full Name | Tucker Medical Group, P.c. |
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Speciality | Family Medicine |
Location | 460 W 2600 S, Bountiful, Utah |
Authorized Official Name and Position | Stephen Richard Tucker (OWNER/PRESIDENT) |
Authorized Official Contact | 8016608687 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Tucker Medical Group, P.c. Po Box 14 Bountiful UT 84011-0014 Ph: (801) 660-8687 | Tucker Medical Group, P.c. 460 W 2600 S Bountiful UT 84010-7716 Ph: (801) 660-8687 |
NPI Number | 1235439811 |
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Provider Enumeration Date | 10/28/2010 |
Last Update Date | 03/21/2014 |
Medicare PECOS PAC ID | 8426073743 |
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Medicare Enrollment ID | O20051005001316 |
Identifier | Type | State | Issuer |
---|---|---|---|
1235439811 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Stephen R Tucker |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1538179247 PECOS PAC ID: 6608821087 Enrollment ID: I20050318000135 |
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