Basic Information
| Provider Information | |||||||||
| NPI: | 1578578324 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | TUCKAHOE ORTHOPAEDIC ASSOCIATES, LTD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 71690 | ||||||||
| Address2: | |||||||||
| City: | RICHMOND | ||||||||
| State: | VA | ||||||||
| PostalCode: | 232551690 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8042852300 | ||||||||
| FaxNumber: | 8042882850 | ||||||||
| Practice Location | |||||||||
| Address1: | 1501 MAPLE AVE | ||||||||
| Address2: | NW MOB SUITE 200 | ||||||||
| City: | RICHMOND | ||||||||
| State: | VA | ||||||||
| PostalCode: | 232262553 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8042852300 | ||||||||
| FaxNumber: | 8042858420 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/30/2006 | ||||||||
| LastUpdateDate: | 10/16/2019 | ||||||||
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| AuthorizedOfficialLastName: | NICHOLS | ||||||||
| AuthorizedOfficialFirstName: | DENISE | ||||||||
| AuthorizedOfficialMiddleName: | WILSON | ||||||||
| AuthorizedOfficialTitleorPosition: | ADMINISTRATOR | ||||||||
| AuthorizedOfficialTelephone: | 8042852300 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
No ID Information.