Tucker Hall

Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Sioux Falls, SD

NPI 1104779131 · NPPES record last updated Feb 18, 2026

Key facts

NPI
1104779131
Entity type
Individual (NPI type 1)
Primary specialty
Student in an Organized Health Care Education/Training Program 390200000X
Practice address
5108 S Tomar Rd
Sioux Falls, SD 57108-2911
Phone
(605) 310-0783
NPI assigned
Feb 18, 2026
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Yes

Addresses

Primary practice location

5108 S Tomar Rd
Sioux Falls, SD 57108-2911

Mailing address

5108 S Tomar Rd
Sioux Falls, SD 57108-2911

Other providers in Sioux Falls, SD

All providers in Sioux Falls, SD · Student in an Organized Health Care Education/Training Program in South Dakota

Sources for this page

Verify at the official NPI Registry.