Provider Demographics
NPI:1518405919
Name:TUCKER, HAL RICHARD (D O)
Entity Type:Individual
Prefix:DR
First Name:HAL
Middle Name:RICHARD
Last Name:TUCKER
Suffix:
Gender:M
Credentials:D O
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1777 HAMILTON DRIVE
Mailing Address - Street 2:BOX 334
Mailing Address - City:VALLEY FORGE
Mailing Address - State:PA
Mailing Address - Zip Code:19481
Mailing Address - Country:US
Mailing Address - Phone:484-682-3069
Mailing Address - Fax:
Practice Address - Street 1:1777 HAMILTON DRIVE
Practice Address - Street 2:
Practice Address - City:VALLEY FORGE
Practice Address - State:PA
Practice Address - Zip Code:19481
Practice Address - Country:US
Practice Address - Phone:484-682-3069
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-06
Last Update Date:2017-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS-006009-L207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine