Provider Demographics
NPI:1407995202
Name:TUTKO, EUGENE G JR (MD)
Entity Type:Individual
Prefix:
First Name:EUGENE
Middle Name:G
Last Name:TUTKO
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2401 WHITTON WAY
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23453-7075
Mailing Address - Country:US
Mailing Address - Phone:757-617-8557
Mailing Address - Fax:
Practice Address - Street 1:MEDICAL DEPARTMENT
Practice Address - Street 2:USS BATAAN
Practice Address - City:FPO
Practice Address - State:AE
Practice Address - Zip Code:09554
Practice Address - Country:US
Practice Address - Phone:757-443-2658
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI39714-20207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine