Donald Tucker PLLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD024197 Issued in TN

Legal business name

DONALD TUCKER PLLC

Practice address

100 William Northern Blvd
Tullahoma, TN 37388-4754

Phone

(931) 454-0489

Fax

(931) 454-2348

NPI assigned

Apr 29, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Donald V Tucker Jr., MD

Title

Medical Doctor

Phone

(931) 454-0489

Specialties & licenses 1

Addresses

Other identifiers 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1209427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219363200000",
    "number": "1154596120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 WILLIAM NORTHERN BLVD",
            "city": "TULLAHOMA",
            "state": "TN",
            "postal_code": "37388",
            "telephone_number": "931-454-0489",
            "fax_number": "931-454-2348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 WILLIAM NORTHERN BLVD",
            "city": "TULLAHOMA",
            "state": "TN",
            "postal_code": "373884754",
            "telephone_number": "931-454-0489",
            "fax_number": "931-454-2348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DONALD TUCKER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-29",
        "last_updated": "2008-08-22",
        "status": "A",
        "authorized_official_last_name": "TUCKER",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "MEDICAL DOCTOR",
        "authorized_official_telephone_number": "931-454-0489",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "MD024197",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1505159",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "4185013",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Tullahoma, TN
• Providers in Tullahoma, TN by specialty
• Internal Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.