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Contact Information

IAN S TUCKER, MD
15 PALOMBA DR
ENFIELD, CT06082-3888
 Phone: 860-951-2198
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family Medicine

207Q00000X 08 Physician/Family Practice
 

Hospitalist

208M00000X
Indicates primary specialty

NPI Profile & details for IAN S TUCKER · (Male)

NPI # 1538130836
Status Active
Credentials MD
Entity Individual
Enumeration date 01/27/2006
Last updated 12/09/2024 - More than a year ago
Sole proprietor 1 Yes
Identifiers
  • CT License # 039732
  • CT License # 39732
  • CT Medicaid 001397323
Hospital affiliation(s)
  • JOHNSON MEMORIAL HOSPITAL - (Acute Care)
    201 CHESTNUT HILL RD
    STAFFORD SPRINGS, CT 06076
  • ST FRANCIS HOSPITAL & MEDICAL CENTER - (Acute Care)
    114 WOODLAND STREET
    HARTFORD, CT 06105
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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