Individual
DR. RAYMOND JAMES RUCKMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
111 W TENTH ST, CARSON CITY, NV 89703-5201
(775) 883-4664
(775) 883-4750
Mailing address
111 W TENTH ST, CARSON CITY, NV 89703-5201
(775) 883-4664
(775) 883-4750
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
638
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12019435
CAQH
—
01
—
CH214X
MEDICARE PTAN
NV
Enumeration date
12/23/2005
Last updated
08/04/2020
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