Tucker, Vivien O
Tucker, Vivien O is an individual health care provider with primary practice located at 13859 Greenridge Rd , Fayetteville AR 72701-0789. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Tucker, Vivien O can be contacted via phone (812) 455-8405.Contact Information
Primary practice address
13859 Greenridge Rd
Fayetteville AR 72701-0789
Phone: (812) 455-8405
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 01039200A | Indiana |
Profile Details
| NPI number | 1821049925 |
|---|---|
| LBN Legal business name | Tucker, Vivien O |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 13th, 2006 |
| Last updated | Mar 2nd, 2020 - about 4 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 | 1821049925 | NPPES |
| Indiana | MEDICAID | 100359550 |
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