Tucker, Brady John
Tucker, Brady John is an individual health care provider with primary practice located at 2121 N 1700 W , Layton UT 84041-8803. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pulmonary Disease, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is his primary health care specialty. Tucker, Brady John can be contacted via phone (801) 773-4840.Contact Information
Primary practice address
2121 N 1700 W
Layton UT 84041-8803
Phone: (801) 773-4840
Fax: (801) 525-8151
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pulmonary Disease | 207RP1001X | 8612587-1206 | Utah |
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | PA-981 | Idaho |
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 8612587-1206 | Utah |
Profile Details
| NPI number | 1174884290 |
|---|---|
| LBN Legal business name | Tucker, Brady John |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 5th, 2012 |
| Last updated | Feb 13th, 2020 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1174884290 | NPPES |
| Idaho | Other | PA-981 | STATE LICENSE |
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