Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

John Tucker McCormick, PA-C

Individual provider Medical Physician Assistant · NPI 1477066926

John Tucker McCormick, PA-C is a Physician Assistant in Fayetteville, Arkansas. Qualified in 2015, 11 years ago. Practices with Ozark Dermatology Clinic, a 15-clinician group and accepts Medicare assignment. Licensed in Arkansas, Oklahoma and Pennsylvania.

Years since qualifying
11
Licensed in
AR, OK, PA
In the registry since
2017
Specialties on file
4
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

4375 N Vantage Dr Ste 305
Fayetteville, AR 72703-4984
Phone: (479) 443-5100
Fax: (479) 443-5117
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence PA-747 (AR)
Medical Physician Assistant Taxonomy 363AM0700X
Medical Physician Assistant Taxonomy 363AM0700X · Licence 4941 (OK)
Medical Physician Assistant Taxonomy 363AM0700X · Licence MA061232 (PA)

Record details

NPI number1477066926
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedNovember 7, 2017
Last updated in NPPESFebruary 16, 2024
Certification dateFebruary 16, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Group practice Ozark Dermatology Clinic — 15 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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