TUCKER BAG LLC NPI 1336596345

NPI Information

  • NPI: 1336596345
  • Provider Name: TUCKER BAG LLC
  • Classification: Obstetrics & Gynecology - 207V00000X
  • Entity Type: Organization
  • Doing Business As: NATHAN PETERSEN, M.D.
  • Address: 6370 W. UNION HILLS DR.
    GLENDALE, AZ
    ZIP 85308
  • Phone: (623) 414-3500

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NPI Details

TUCKER BAG LLC is an obstetrics gynecology in Glendale, AZ. The provider is an obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. TUCKER BAG LLC NPI is 1336596345. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Nathan Petersen, M.d..

The provider's business location address is:

6370 W. UNION HILLS DR.
GLENDALE, AZ
ZIP 85308
Phone: (623) 414-3500
Fax: (623) 374-2549

The provider's authorized official is Nathan Jeffrey Petersen .
The authorized official title is Member and has the following contact phone number (623) 414-3500.

The enumeration date for this NPI number is 5/19/2016 and was last updated on 5/19/2016.

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
1207V00000XObstetrics & Gynecology51043ARIZONAYes

What is NPI?

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This page was last updated on: 11/21/2025

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