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NPI Profile for Dr JACK R TACKER in POULSBO, WA.
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
General Practice |
208D00000X | 99 | Physician/Undefined Physician type[6] |
| NPI # | 1336379403 |
|
| Status | Active | |
| Credentials | MD | |
| Entity | Individual | |
| Enumeration date | 07/22/2009 | |
| Last updated | 06/05/2013 - About 13 years ago | |
| Sole proprietor 1 | Yes | |
| Identifiers |
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|
| Hospital affiliation(s) | Not Available |
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JACK R TACKER
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JACK R TACKER, MD