Tucker, Douglas
Tucker, Douglas is an individual health care provider with primary practice located at 2500 N State St Department Of Anesthesiology, Jackson MS 39216-4500. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Anesthesiology, Allopathic & Osteopathic Physicians / Pain Medicine. Allopathic & Osteopathic Physicians / Pain Medicine is his primary health care specialty. Tucker, Douglas can be contacted via phone (601) 984-5914.Contact Information
Primary practice address
2500 N State St Department Of Anesthesiology
Jackson MS 39216-4500
Phone: (601) 984-5914
Fax: (601) 984-5915
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | 23632 | Mississippi |
| Allopathic & Osteopathic Physicians / Pain Medicine | 207LP2900X | 23632 | Mississippi |
Profile Details
| NPI number | 1043574445 |
|---|---|
| LBN Legal business name | Tucker, Douglas |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 29th, 2012 |
| Last updated | Nov 21st, 2023 - about last year |
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 | 1043574445 | NPPES |
| Mississippi | MEDICAID | 02755554 |
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