Provider Demographics
NPI:1447533526
Name:SIMMONS, TUCKER DEE I
Entity type:Individual
Prefix:DR
First Name:TUCKER
Middle Name:DEE
Last Name:SIMMONS
Suffix:I
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2515 CRAWFORD RD
Mailing Address - Street 2:
Mailing Address - City:PHENIX CITY
Mailing Address - State:AL
Mailing Address - Zip Code:36867-3629
Mailing Address - Country:US
Mailing Address - Phone:334-297-3722
Mailing Address - Fax:334-297-5223
Practice Address - Street 1:2515 CRAWFORD RD
Practice Address - Street 2:
Practice Address - City:PHENIX CITY
Practice Address - State:AL
Practice Address - Zip Code:36867-3629
Practice Address - Country:US
Practice Address - Phone:334-297-3722
Practice Address - Fax:334-297-5223
Is Sole Proprietor?:No
Enumeration Date:2011-09-24
Last Update Date:2011-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL151701835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatric