DR. TUCKER MARTIN HARRIS (NPI# 1629232418) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629232418 |
| Entity Type | Individual |
| Full Name | DR. TUCKER MARTIN HARRIS |
| Credential | M.D. |
| Practice Address |
4000 Medical Center Dr # 117 Fayetteville NY 13066 |
| Mailing Address |
4000 Medical Center Dr # 117 Fayetteville NY 13066-6631 |
| Practice Telephone | 3157441505 |
| Practice Fax Number | 3152141924 |
| Mailing Telephone | 3157441505 |
| Mailing Fax Number | 3152141924 |
| Enumeration Date | 2008-07-11 |
| Last Update Date | 2018-10-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Y00000X | Otolaryngology | 258471 | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | LICENSE | 258471 | 01 |
| NY | 03274408 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 100 John Roemmelt Dr, Suite 201, Horseheads, NY 148458301 | 6077952850 | 6077951205 |
| 301 Prospect Ave, Syracuse, NY 132031899 | 3154485111 |
| Street Address |
4000 MEDICAL CENTER DR # 117 |
| City | FAYETTEVILLE |
| State | NY |
| Zip Code | 13066 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457819963 | Word Wellness Center, LLC | Psychologist | 6836 E Genesee Street, Suite A, Fayetteville, NY 13066 | 2019-03-05 |
| 1629529060 | Lorna Boyer Chase | Marriage & Family Therapist | 109 White Heron Circle, Fayetteville, NY 13066 | 2016-10-20 |
| 1699221432 | Roman Batyuk | Nurse Practitioner | 4100 Medical Center Drive, Fayetteville, NY 13066 | 2016-08-31 |
| 1427405133 | National Eye Care, Inc | Optometrist | 5160 Kinloch Circle, Fayetteville, NY 13066 | 2016-05-23 |
| 1013375328 | Kristin Kukenberger | Chiropractor | 7000 E Genesee St Bldg B, Fayetteville, NY 13066 | 2016-02-01 |
| 1124394671 | Susan Hartman Brenizer | Marriage & Family Therapist | 7000 E Genesee St Lyndon Office Park, Bldg. A, Second Floor (upper Level), Fayetteville, NY 13066 | 2012-03-29 |
| 1245541432 | Rene L Converse | Occupational Therapist | 7200 E. Genesee Street, Fayetteville, NY 13066 | 2010-06-23 |
| 1689815805 | Menorah Park Group Residents | Clinic/Center | 12 Jamar Drive, Dewitt, NY 13066 | 2009-03-18 |
| 1063677458 | John Marcena Glezen | Obstetrics & Gynecology | 1 The Gazebo, Fayetteville, NY 13066 | 2008-07-24 |
| 1770746810 | Karrie D Damm | Marriage & Family Therapist | 7030 E Genesse St, Ste 101, Fayetteville, NY 13066 | 2008-07-09 |
| Find all providers in zip 13066 | ||||
| Taxonomy Code | 207Y00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912911934 | Carlton Lee Chambers IIi | Otolaryngology | 228 E Sunbridge Dr, V A Ent Clinic, Fayetteville, AR 72703-1823 | 2006-07-27 |
| 1346206976 | Kenneth Thomas Bellian | Otolaryngology | 1839 Quiet Cove, Fayetteville, NC 28304-3857 | 2006-04-22 |
| 1417935461 | Sabina Petra Francis | Otolaryngology | 2053 Valleygate Drive, Suite 101, Fayetteville, NC 28304 | 2006-01-09 |
| 1316346976 | Cumberland County Hospital System Inc | Otolaryngology | 1565 Purdue Dr, Suite 301, Fayetteville, NC 28303-5536 | 2014-08-20 |
| 1760780688 | Lincoln Ear Nose and Throat | Otolaryngology | 108 Medical Center Blvd, Suite 175, Fayetteville, TN 37334-2741 | 2011-03-01 |
| 1790001758 | Shan Tang | Otolaryngology | 1839 Quiet Cv, Fayetteville, NC 28304-3857 | 2010-04-15 |
| 1104023951 | Elizabeth Mccurdy Hueman | Otolaryngology | 1839 Quiet Cv, Fayetteville, NC 28304-3857 | 2007-06-27 |
| 1376509778 | William James Wiggs Jr. | Otolaryngology | 1839 Quiet Cove, Fayetteville, NC 28304-3857 | 2006-04-25 |
| 1255397881 | Robert Richard Friedrichs | Otolaryngology | 2053 Valleygate Drive, Ste. 101, Fayetteville, NC 28304-3983 | 2006-04-22 |
| 1164488797 | Steven Thomas Pantelakos | Otolaryngology | 1839 Quiet Cove, Fayetteville, NC 28304-3857 | 2006-04-22 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 13066 |
Please comment or provide details below to improve the information on DR. TUCKER MARTIN HARRIS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.