Provider Demographics
NPI:1700290350
Name:TUCKER, PATRICK W (RPSGT)
Entity type:Individual
Prefix:
First Name:PATRICK
Middle Name:W
Last Name:TUCKER
Suffix:
Gender:M
Credentials:RPSGT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1375 E 20TH AVE
Mailing Address - Street 2:SLEEP APNEA CLINIC
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80205-5422
Mailing Address - Country:US
Mailing Address - Phone:303-861-3640
Mailing Address - Fax:
Practice Address - Street 1:1375 E 20TH AVE
Practice Address - Street 2:SLEEP APNEA CLINIC
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80205-5422
Practice Address - Country:US
Practice Address - Phone:303-861-3640
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-11
Last Update Date:2014-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MORPSGT #2747225500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225500000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/Technologist