Tucker, Juan L
Tucker, Juan L is an sole proprietor health care provider with primary practice located at 6051 U S Highway 49 , Hattiesburg MS 39401-7200. He recently has only one registered license in Technologists, Technicians & Other Technical Service Providers / Perfusionist, which is considered as his primary health care specialty. Tucker, Juan L can be contacted via phone (601) 288-4243.Contact Information
Primary practice address
6051 U S Highway 49
Hattiesburg MS 39401-7200
Phone: (601) 288-4243
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Technologists, Technicians & Other Technical Service Providers / Perfusionist | 242T00000X |
Profile Details
| NPI number | 1881329225 |
|---|---|
| LBN Legal business name | Tucker, Juan L |
| Credentials | Certified Clinical Perfusionist (CCP) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 20th, 2022 |
| Last updated | Jul 20th, 2022 - about 2 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 | 1881329225 | NPPES |
| Mississippi | MEDICAID | 242T00000X |
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