Provider Demographics
NPI:1629153127
Name:TOCKER, ALLAN S (OD)
Entity Type:Individual
Prefix:MR
First Name:ALLAN
Middle Name:S
Last Name:TOCKER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:ALLAN
Other - Middle Name:S
Other - Last Name:TOCKER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1950 OLD GALLOWS RD STE 520
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-3970
Mailing Address - Country:US
Mailing Address - Phone:703-847-8899
Mailing Address - Fax:571-223-6780
Practice Address - Street 1:4605 KIRKWOOD HWY STE A
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-5005
Practice Address - Country:US
Practice Address - Phone:302-999-7171
Practice Address - Fax:302-993-7863
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2022-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG002995152W00000X
DE1061152W00000X
DEI3-0001164152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE412105Medicare PIN