Steven R. Tucker P.S.C.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

4475 Issued in KY

Legal business name

STEVEN R. TUCKER P.S.C.

Practice address

909 Scherm Rd
Owensboro, KY 42301-6048

Phone

(270) 926-4107

Fax

(270) 926-4166

NPI assigned

Apr 16, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Steven R. Tucker, D.M.D.NPI 1144219643

Title

Ceo

Phone

(270) 926-4107

Specialties & licenses 1

Addresses

Other identifiers 4

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Steven R. Tucker, D.M.D.

  • Oral and Maxillofacial Surgery (Dentist)
  • Lexington, KY
  • NPI 1144219643
  NPD (past) Authorized official
• Eric R Schmidt, DMD

  • Oral and Maxillofacial Surgery (Dentist)
  • Owensboro, KY
  • NPI 1811001340
  NPD (past)

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1871718833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 SCHERM RD",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423016048",
            "telephone_number": "270-926-4107",
            "fax_number": "270-926-4166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 SCHERM RD",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423016048",
            "telephone_number": "270-926-4107",
            "fax_number": "270-926-4166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEVEN R. TUCKER P.S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TUCKER",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "270-926-4107",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "KY",
            "license": "4475",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64044753",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "60044757",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS",
            "identifier": "000000208416",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65912016",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Oral and Maxillofacial Surgery (Dentist) in Owensboro, KY
• Providers in Owensboro, KY by specialty
• Oral and Maxillofacial Surgery (Dentist) in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.