TUCKER JEPPSON DO NPI 1104455922

NPI Information

  • NPI: 1104455922
  • Provider Name: TUCKER JEPPSON, DO
  • Classification: Radiology - 2085R0202X
  • Specialization: Diagnostic Radiology
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 220 W 3RD ST
    MOSCOW, ID
    ZIP 83843
  • Phone: (208) 882-8369

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NPI Details

Tucker Jeppson, DO is a diagnostic radiology radiology in Moscow, ID with 6 years of experience. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. Tucker Jeppson, DO NPI is 1104455922. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: PACIFIC NW UN OF HS, COL OF OSTEOPATHIC MEDICINE
Graduation Year:2020

The provider's business location address is:

220 W 3RD ST
MOSCOW, ID
ZIP 83843-203
Phone: (208) 882-8369

The NPI 1104455922 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 4/3/2020 and was last updated on 8/18/2025.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12085R0202XRadiologyDiagnostic Radiology9861270IDAHOYes

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: 11/21/2025

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