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Individual

DR. TAMMY JEAN HALE TUCKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.O.

Contact information

Practice address
2905 S WALTON BLVD, STE 17, BENTONVILLE, AR 72712-6730
(479) 657-6800
(479) 268-4272
Mailing address
103 SOMERSET, BENTONVILLE, AR 72712-4091
(870) 405-8579

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
E3741
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
150124003
AR
Enumeration date
09/07/2005
Last updated
11/16/2012
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