| Tucker Family Medicine Psc | |
|
105 Greenbriar Dr Suite B Campbellsville KY 42718-9617 | |
| (270) 465-0191 | |
| Not Available |
| Full Name | Tucker Family Medicine Psc |
|---|---|
| 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 |
|---|---|
| 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 |
|---|---|
| Provider Enumeration Date | 05/08/2014 |
| Last Update Date | 06/24/2014 |
| Medicare PECOS PAC ID | 3072737089 |
|---|---|
| Medicare Enrollment ID | O20140613000924 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275944589 | NPI | - | NPPES |
| 7100230150 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | KY03404 (Kentucky) | Primary |
| Provider Name | Summer Raye Tucker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659505113 PECOS PAC ID: 3779617295 Enrollment ID: I20110930000310 |
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