Most Relevant Information
Provider Data
| NPI Number: | 1003264904 |
| Provider Name: | KATIE KUBERG TUCKER D.O. |
| Entity Type: | Individual |
| Taxonomy Code: | 208000000X |
| Specialty: | Pediatrics |
| License Number: | DO.2031 |
Most Important Dates
| Enumeration Date: | 06/01/2016 |
| Last Updated: | 08/26/2020 |
Provider Practice Location
22136 MEDICAL VILLAGE DRIVE
ATHENS
AL
35613
Practice Location Phone/Fax
| Phone: | 2566485598 |
| Fax: | 8336031295 |
Provider Mailing Location
22136 MEDICAL VILLAGE DRIVE
ATHENS
AL
356132940
Provider Mailing Phone/Fax
| Phone: | 2566485598 |
| Fax: | 8336031295 |
Suggested EMR
Pediatrics EMR