Tuckman, Glenn A

Tuckman, Glenn A is an sole proprietor health care provider with primary practice located at 3738 Landmark Dr Ste D, Lafayette IN 47905-6654. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Body Imaging, Allopathic & Osteopathic Physicians / Diagnostic Radiology. Allopathic & Osteopathic Physicians / Diagnostic Radiology is his primary health care specialty. Tuckman, Glenn A can be contacted via phone (765) 449-7984.

Contact Information

Primary practice address
3738 Landmark Dr Ste D Lafayette IN 47905-6654
Phone: (765) 449-7984
Fax: (765) 449-9791
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Body Imaging 2085B0100X MD-40539 Iowa
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X MD-40539 Iowa
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 01039553A Indiana

Profile Details

NPI number 1821091620
LBN Legal business name Tuckman, Glenn A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 24th, 2005
Last updated Dec 9th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1821091620 NPPES
Indiana MEDICAID 200020370B
Indiana MEDICAID 64882822

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