Tucker, Kelly Wade

Tucker, Kelly Wade is an individual health care provider with primary practice located at 2520 W 16Th St , Greeley CO 80634-4902. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Tucker, Kelly Wade can be contacted via phone (970) 356-2520.

Contact Information

Primary practice address
2520 W 16Th St Greeley CO 80634-4902
Phone: (970) 356-2520
Fax: (970) 356-6928
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 32537 Colorado

Profile Details

NPI number 1871568782
LBN Legal business name Tucker, Kelly Wade
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 22nd, 2006
Last updated Oct 18th, 2007 - about 17 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 1871568782 NPPES
Colorado MEDICAID 01325372

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