Tucker, Charles L

Tucker, Charles L is an individual health care provider with primary practice located at 195 Hospital Dr , Cherokee Village AR 72529-7314. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Tucker, Charles L can be contacted via phone (870) 257-6060.

Contact Information

Primary practice address
195 Hospital Dr Cherokee Village AR 72529-7314
Fax: (870) 257-7667
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X C3379 Arkansas

Profile Details

NPI number 1639173396
LBN Legal business name Tucker, Charles L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 10th, 2005
Last updated Jul 27th, 2013 - about 12 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1639173396 NPPES
Arkansas MEDICAID 105959001

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