Tucker, Kenneth
Tucker, Kenneth is an individual health care provider with primary practice located at 11900 E 12 Mile Rd Suite 300, Warren MI 48093-3400. He recently has only one registered license in Allopathic & Osteopathic Physicians / Hematology & Oncology, which is considered as his primary health care specialty. Tucker, Kenneth can be contacted via phone (586) 751-2072.Contact Information
Primary practice address
11900 E 12 Mile Rd Suite 300
Warren MI 48093-3400
Phone: (586) 751-2072
Fax: (586) 751-1302
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Hematology & Oncology | 207RH0003X | 4301024231 | Michigan |
Profile Details
NPI number | 1669479846 |
---|---|
LBN Legal business name | Tucker, Kenneth |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jul 5th, 2005 |
Last updated | Feb 16th, 2015 - about 10 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 | 1669479846 | NPPES |
Michigan | Other | 700H273300 | BCBSM |
Michigan | MEDICAID | 1672544 | BCBSM |
Michigan | Other | KT024231 | BCBSM |
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