Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 1975 | TN |
N | 208600000X | Surgeon | 1975 | TN |
Y | 2086S0102X | Surgical Critical Care | 03291 | KY |
N | 2086S0102X | Surgical Critical Care | 1975 | TN |
N | 2086S0127X | Trauma Surgeon | 1975 | TN |
NPI | 1124289996 |
---|---|
Provider Name | Dr. Brian Keith Tucker |
First Address | Lexington, KY 40536-0001 |
Second Address | Lexington, KY 40536-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2008 |
Last Update Date | 13/07/2020 |