Provider Demographics
NPI:1710259072
Name:DAVID B. TUCHINSKY, D.C., PLLC
Entity Type:Organization
Organization Name:DAVID B. TUCHINSKY, D.C., PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ERICA
Authorized Official - Middle Name:M
Authorized Official - Last Name:DEW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-540-8029
Mailing Address - Street 1:100 WHETSTONE PL
Mailing Address - Street 2:SUITE 310
Mailing Address - City:ST AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32086-5774
Mailing Address - Country:US
Mailing Address - Phone:904-217-7450
Mailing Address - Fax:904-217-7483
Practice Address - Street 1:100 WHETSTONE PL
Practice Address - Street 2:SUITE 310
Practice Address - City:ST AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32086-5774
Practice Address - Country:US
Practice Address - Phone:904-217-7450
Practice Address - Fax:904-217-7483
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-02
Last Update Date:2012-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH003617111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL380011300Medicaid
FL88669Medicare UPIN