Individual
DR. GARY W RUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1165 E CHERRY ST, TROY, MO 63379-1520
(636) 528-7722
(636) 528-7744
Mailing address
1165 E CHERRY ST, PO BOX 312, TROY, MO 63379-1520
(636) 528-7722
(636) 528-7744
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
R6346
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
247744709
—
MO
Enumeration date
12/23/2005
Last updated
07/05/2013
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