DALE TUCKER MD NPI 1720024425

NPI Information

NPI: 1720024425
Provider Name: DALE TUCKER, MD
Classification: Family Medicine - 207Q00000X
Entity Type: Individual
PECOS Registration: Yes
Address: 1506 ALICE ST
WAYCROSS, GA
ZIP 31501
Phone: (912) 584-6500

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NPI Details

Dale Tucker, MD is a family medicine in Waycross, GA with 30 years of experience. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. Dale Tucker, MD NPI is 1720024425. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: MERCER UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:1996

The provider's business location address is:

1506 ALICE ST
WAYCROSS, GA
ZIP 31501-531
Phone: (912) 584-6500

The NPI 1720024425 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 following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

Established patient office or other outpatient visit, 30-39 minutes (HCPCS:99214)
Established patient office or other outpatient visit, 20-29 minutes (HCPCS:99213)
New patient office or other outpatient visit, 30-44 minutes (HCPCS:99203)
Detection test by immunoassay with direct visual observation for influenza virus (HCPCS:87804)
Automated urinalysis test (HCPCS:81003)
New patient office or other outpatient visit, 45-59 minutes (HCPCS:99204)
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report (HCPCS:93000)

The enumeration date for this NPI number is 6/21/2006 and was last updated on 5/2/2024.

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	License Number	License State	Primary
1	207P00000X	Emergency Medicine	ME76518	FLORIDA	No
2	207Q00000X	Family Medicine	48092	GEORGIA	No
3	207Q00000X	Family Medicine	ME76518	FLORIDA	Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	930119999	OTHER	FLORIDA	RAILROAD MEDICARE
2	35915	OTHER	FLORIDA	BCBS
3	261605000	MEDICAID	FLORIDA

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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