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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 9 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 1669479846 NPPES
Michigan Other 700H273300 BCBSM
Michigan MEDICAID 1672544 BCBSM
Michigan Other KT024231 BCBSM

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