Tucker, Mark A

Tucker, Mark A is an individual health care provider with primary practice located at 650 High St , Danville KY 40422-1235. He recently has only one registered license in Other Service Providers / Case Manager/Care Coordinator, which is considered as his primary health care specialty. Tucker, Mark A can be contacted via phone (859) 253-1686.

Contact Information

Primary practice address
650 High St Danville KY 40422-1235
Fax: (859) 254-2743
Website:

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Case Manager/Care Coordinator 171M00000X 3334

Profile Details

NPI number 1316127962
LBN Legal business name Tucker, Mark A
Credentials Bachelor of Arts (BA)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 13th, 2007
Last updated Nov 13th, 2007 - about 18 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 1316127962 NPPES
Kentucky MEDICAID 30615058

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