Tucker, James L

Tucker, James L is an sole proprietor health care provider with primary practice located at 124 E Miracle Strip Pkwy Suite 302, Mary Esther FL 32569-1988. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Clinical Child & Adolescent. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Tucker, James L can be contacted via phone (850) 243-8086.

Contact Information

Primary practice address
124 E Miracle Strip Pkwy Suite 302 Mary Esther FL 32569-1988
Phone: (850) 243-8086
Fax: (850) 243-2702
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 732 Colorado
Behavioral Health & Social Service Providers / Clinical Child & Adolescent 103TC2200X 732 Colorado
Behavioral Health & Social Service Providers / Clinical 103TC0700X PY9444 Florida

Profile Details

NPI number 1700937638
LBN Legal business name Tucker, James L
Credentials PH.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 16th, 2007
Last updated Jan 29th, 2016 - about 8 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 1700937638 NPPES
Florida Other K3215 MEDICARE GROUP

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