Provider Demographics
NPI:1194362293
Name:HALL, TAMARA (DACOM)
Entity type:Individual
Prefix:DR
First Name:TAMARA
Middle Name:
Last Name:HALL
Suffix:
Gender:
Credentials:DACOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18972 E OAKRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:CLAREMORE
Mailing Address - State:OK
Mailing Address - Zip Code:74017-0954
Mailing Address - Country:US
Mailing Address - Phone:918-864-6787
Mailing Address - Fax:
Practice Address - Street 1:1926 S HIGHWAY 66
Practice Address - Street 2:
Practice Address - City:CLAREMORE
Practice Address - State:OK
Practice Address - Zip Code:74019-4371
Practice Address - Country:US
Practice Address - Phone:918-404-5765
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-08
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist