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TUCKER CHIROPRACTIC CENTER PLLC NPI 1104848001


NPI Information

NPI: 1104848001
Provider Name: TUCKER CHIROPRACTIC CENTER PLLC
Classification: Chiropractor - 111N00000X
Entity Type: Organization

CLIA Number: 04D2157417

Address:
1179 S GENTRY BLVD
GENTRY, AR
ZIP 72734
Phone: (479) 736-8900
Get Directions

TUCKER CHIROPRACTIC CENTER PLLC is a chiropractor in Gentry, AR. The provider is a provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. TUCKER CHIROPRACTIC CENTER PLLC NPI is 1104848001. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1179 S GENTRY BLVD
GENTRY, AR
ZIP 72734-624
Phone: (479) 736-8900
Fax: (479) 736-5133

The provider's authorized official is Guy E Tucker .
The authorized official title is Owner and has the following contact phone number (479) 736-8900.

The CLIA number assigned to this NPI record is 04D2157417 - other practitioner with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/23/2006 and was last updated on 4/19/2010.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1111N00000XChiropractorYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1181145718MEDICAIDARKANSAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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