Individual
LORI TUCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
904 HARRISON ST, PRINCETON, WV 24740
(304) 431-7100
(304) 431-7112
Mailing address
PO BOX 1138, PRINCETON, WV 24740
(304) 431-7100
(304) 431-7112
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
1960
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1808681000
—
WV
Enumeration date
08/11/2006
Last updated
04/08/2021
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