| Dr David John Tucker, MD | |
|
1101 Jackson St Sw, Gravette, AR 72736-9121 | |
| (479) 787-5221 | |
| (479) 787-5613 |
| Full Name | Dr David John Tucker |
|---|---|
| Gender | Male |
| Speciality | Family Practice |
| Experience | 42 Years |
| Location | 1101 Jackson St Sw, Gravette, Arkansas |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023076619 | NPI | - | NPPES |
| 112423001 | Medicaid | AR | |
| 50654 | Other | AR | AR BCBS |
| 100726240D | Other | OK | OK MEDICAID GROUP NUMBER |
| 100061170A | Medicaid | OK | |
| 202310207 | Medicaid | MO | |
| P00144854 | Other | AR | RAILROAD MEDICARE NUMBER |
| P00894372 | Other | AR | OCH RR MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 2013042315 (Missouri) | Secondary |
| 207Q00000X | Family Medicine | R3698 (Arkansas) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Ozarks Community Hospital Of Gravette | Gravette, AR | Hospital |
| Mercy Hospital Northwest Arkansas | Rogers, AR | Hospital |
| Siloam Springs Regional Hospital | Siloam springs, AR | Hospital |
| Siloam Healthcare, Llc | Siloam springs, AR | Nursing home |
| Concordia Nursing & Rehab, Llc | Bella vista, AR | Nursing home |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Sgoh Acquisition Inc | 5092616276 | 74 |
| Sgoh Acquisition Inc | 5092616276 | 74 |
| Entity Name | Sgoh Acquisition Inc |
|---|---|
| Entity Type | Part B Supplier - Hospital Department(s) |
| Entity Identifiers | NPI Number: 1568643005 PECOS PAC ID: 5092616276 Enrollment ID: O20081016000559 |
| Entity Name | Sgoh Acquisition Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1568643005 PECOS PAC ID: 5092616276 Enrollment ID: O20190905000100 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr David John Tucker, MD 1101 Jackson St Sw, Gravette, AR 72736-9121 Ph: (479) 787-5221 | Dr David John Tucker, MD 1101 Jackson St Sw, Gravette, AR 72736-9121 Ph: (479) 787-5221 |
Dr. Nancy L Jones, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1101 Jackson St Sw, Gravette, AR 72736 Phone: 479-787-5221 Fax: 479-787-5613 | |
Rayetta Eaton, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 1101 Jackson St Sw, Gravette, AR 72736 Phone: 479-787-5291 Fax: 479-344-6404 | |
Dr. Vijay Kumar Kannam, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1101 Jackson St Sw, Gravette, AR 72736 Phone: 479-787-5221 Fax: 479-787-5613 | |
Dr. William Frank Webb, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 1101 Jackson St Sw, Gravette, AR 72736 Phone: 479-787-5221 Fax: 479-787-5613 | |
Dr. Kenneth Marcus Poemoceah, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1102 Jackson St Sw, Gravette, AR 72736 Phone: 479-787-5221 Fax: 479-787-5613 |