Provider Demographics
NPI:1336329929
Name:JON B TUCKER MD PC
Entity Type:Organization
Organization Name:JON B TUCKER MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JON
Authorized Official - Middle Name:B
Authorized Official - Last Name:TUCKER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:412-310-6177
Mailing Address - Street 1:1082 BOWER HILL RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15243-1324
Mailing Address - Country:US
Mailing Address - Phone:412-276-0267
Mailing Address - Fax:412-276-7215
Practice Address - Street 1:1082 BOWER HILL RD
Practice Address - Street 2:SUITE 100
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15243-1324
Practice Address - Country:US
Practice Address - Phone:412-276-0267
Practice Address - Fax:412-276-7215
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-12
Last Update Date:2011-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty