Provider Demographics
NPI:1629235049
Name:TUCKER, SCOTT ANDREW (MD)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:ANDREW
Last Name:TUCKER
Suffix:
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 1:15 LUND RD
Mailing Address - Street 2:
Mailing Address - City:SACO
Mailing Address - State:ME
Mailing Address - Zip Code:04072-1806
Mailing Address - Country:US
Mailing Address - Phone:207-294-8960
Mailing Address - Fax:207-294-8965
Practice Address - Street 1:15 LUND RD
Practice Address - Street 2:
Practice Address - City:SACO
Practice Address - State:ME
Practice Address - Zip Code:04072-1806
Practice Address - Country:US
Practice Address - Phone:207-294-8960
Practice Address - Fax:207-294-8965
Is Sole Proprietor?:No
Enumeration Date:2008-05-22
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMD28066207XX0005X, 207X00000X
LAMD.203208207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery