Provider Demographics
NPI:1023142445
Name:TUCKER, BARRY D (PHARMD)
Entity type:Individual
Prefix:DR
First Name:BARRY
Middle Name:D
Last Name:TUCKER
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 10269
Mailing Address - Street 2:2907 SAINT JOHNS DRIVE
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37129-0006
Mailing Address - Country:US
Mailing Address - Phone:919-949-4259
Mailing Address - Fax:
Practice Address - Street 1:2907 SAINT JOHNS DR
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129-0806
Practice Address - Country:US
Practice Address - Phone:919-949-4259
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN8251183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist