Individual
DR. RAYMOND JAMES RUCKMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
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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