Charles Douglas Tucker, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

22873 Issued in KY

Practice address

4007 Wiswell Rd W
Murray, KY 42071

Phone

(270) 753-8724

NPI assigned

Dec 5, 2006

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 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Westowne Pharmacy Inc

  • Durable Medical Equipment & Medical Supplies
  • Paducah, KY
  • NPI 1275723710
  NPD Authorized official
• West Towne Pharmacy Inc

  • Community/Retail Pharmacy
  • Paducah, KY
  • NPI 1316940885
  NPD
• Marshall County Medical Associates

  • Family Medicine Physician
  • Benton, KY
  • NPI 1477605988
  NPD (past)
• Murray-Calloway County Public Hospital Corporation

  • Rural Acute Care Hospital
  • Murray, KY
  • NPI 1063549814
  NPD (past)

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721865600000",
    "number": "1295893030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4007 WISWELL RD W",
            "city": "MURRAY",
            "state": "KY",
            "postal_code": "420714492",
            "telephone_number": "270-293-7019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4007 WISWELL RD W",
            "city": "MURRAY",
            "state": "KY",
            "postal_code": "42071",
            "telephone_number": "270-753-8724"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 S 8th St",
            "address_2": "Suite 205 E",
            "address_purpose": "LOCATION",
            "city": "Murray",
            "state": "KY",
            "postal_code": "420712400",
            "country_code": "US",
            "telephone_number": "270-753-8724",
            "fax_number": "270-767-3638",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "CHARLES",
        "middle_name": "DOUGLAS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-05",
        "last_updated": "2024-07-25",
        "certification_date": "2024-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "KY",
            "license": "22873",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "6885",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64228737",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "CK4330",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Steven Lee Trevathan, M.D.
• Karla Roy Turley, MD
• Cadelia A Turpin, M.S.,R.D.,L.D.
• John Edward Tveite, M.D.
• Gordana Unici, MA
• Rachelle Valentine

• All providers in Murray, KY
• Surgery Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2024; 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.