Provider Demographics
NPI:1467557470
Name:FRENCH, LIESEL TUCKER (MD)
Entity Type:Individual
Prefix:
First Name:LIESEL
Middle Name:TUCKER
Last Name:FRENCH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LIESEL
Other - Middle Name:LOUISE
Other - Last Name:TUCKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:806 ST VINCENTS DR
Mailing Address - Street 2:STE 615
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35205
Mailing Address - Country:US
Mailing Address - Phone:205-933-2750
Mailing Address - Fax:205-939-4614
Practice Address - Street 1:806 ST VINCENTS DR
Practice Address - Street 2:STE 615
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35205
Practice Address - Country:US
Practice Address - Phone:205-933-2750
Practice Address - Fax:205-939-4614
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00021242208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
H02207Medicare UPIN