Forrest Lee Tucker, MD

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

0101035168 Issued in VA

Practice address

101 Elm Ave SE
Administrative Suite
Roanoke, VA 24013-2222

Phone

(540) 985-8592

Fax

(540) 985-0475

NPI assigned

Jul 20, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1121817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1295734226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 ELM AVE SE",
            "address_2": "ADMINISTRATIVE SUITE",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240132222",
            "telephone_number": "540-985-8592",
            "fax_number": "540-985-0475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 ELM AVE SE",
            "address_2": "ADMINISTRATIVE SUITE",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240132222",
            "telephone_number": "540-985-8592",
            "fax_number": "540-985-0475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "FORREST",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-20",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "VA",
            "license": "0101035168",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6600061000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Isabelle Dyer Tubbs, FNP-BC
• Tuck Chiropractic Corporation
• Cynthia Tuck
• Margaret Tuck, PA-C
• Andre D'Shon Tucker, ED.S.
• Isabel Ann Tumminello, RN
• Akilah D Tunsill, APRN
• Ashley Nicole Turner
• Britney T Turner, PTA
• Cannon E Turner, M.D.

• Anatomic Pathology & Clinical Pathology Physician in Roanoke, VA
• Providers in Roanoke, VA by specialty
• Anatomic Pathology & Clinical Pathology Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.