| Organization Name: | DR PAMELA TUCK LLC |
| NPI Number: | 1558479162 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | PAMELA P TUCK (OWNER) |
| Mailing Address: | 300 Taylor Rd Suite 600 Montgomery |
| State: | AL US |
| Postal Code: | 361173521 |
| Phone Number: | 3343967865 |
| Fax Number: | 3343967868 |
| NPI Enumeration Date: | 08/25/2006 |
| NPI Last Update Date: | 12/11/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 00023723 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AL |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |