Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | OS014617 | PA |
NPI | 1013987643 |
---|---|
Provider Name | Dr. Joshua Alan Tuck |
First Address | Erie, PA 16505-2571 |
Second Address | Erie, PA 16509-2601 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/01/2006 |
Last Update Date | 05/01/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1028263340001 | (05) | PA |