Basic Information
| Provider Information | |||||||||
| NPI: | 1427285691 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TUCKER | ||||||||
| FirstName: | SYREETA | ||||||||
| MiddleName: | ALSTON | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1541 | ||||||||
| Address2: | |||||||||
| City: | OXFORD | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275651541 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2524928576 | ||||||||
| FaxNumber: | 2524927464 | ||||||||
| Practice Location | |||||||||
| Address1: | 1209 SE INDUSTRY DR | ||||||||
| Address2: | |||||||||
| City: | OXFORD | ||||||||
| State: | NC | ||||||||
| PostalCode: | 27536 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2524928576 | ||||||||
| FaxNumber: | 2524927464 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/16/2009 | ||||||||
| LastUpdateDate: | 04/29/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 2013-01118 | NC | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
No ID Information.