Dr. Gladstone A Tucker
Geriatric Medicine
1606 Castleberry Dr
Marion
, Illinois 62959-1586
Dr. Gladstone A Tucker
Geriatric Medicine
1606 Castleberry Dr
Marion
, Illinois 62959-1586
(660) 463-1367
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About
Features
Specialties
- Geriatric Medicine
Languages spoken
- English
Location
First Address
- Dr. Gladstone A Tucker
- Po Box 752
- Concordia, MO
- Zip : 64020-0752
- Fax : (660) 463-1367
- Phone : (660) 463-1365
Second Address
- Dr. Gladstone A Tucker
- 1606 Castleberry Dr
- Marion, IL
- Zip : 62959-1586
- Fax : (618) 993-0592
- Phone : (618) 997-9519
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207RG0300X | Geriatric Medicine | 036111926 | IL |
National Provider Identifier
| NPI | 1023087012 |
|---|---|
| Provider Name | Dr. Gladstone A Tucker |
| First Address | Concordia, MO 64020-0752 |
| Second Address | Marion, IL 62959-1586 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 14/03/2006 |
| Last Update Date | 25/07/2012 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 036111926 | (05) | IL |
| 07332006 | BCBS (01) | IL |
| 229260 | COVENTRY (01) | IL |
| 252364 | HARMONY (01) | IL |
| 699628 | HEALTHLINK (01) | IL |
| 9367182 | CIGNA (01) | IL |
| H81285 | (02) | |
| P00239844 | MEDICARE - RAILROAD (01) | IL |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.