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Individual

DR. NATHAN RUCKER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHARMD

Contact information

Practice address
465 GOODMAN RD E, SOUTHAVEN, MS 38671-9525
(662) 349-3740
Mailing address
465 GOODMAN RD E, SOUTHAVEN, MS 38671-9525
(662) 349-3740

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
36146
TN
183500000X
Pharmacist
Primary
E-11822
MS

Other

Enumeration date
11/02/2020
Last updated
11/02/2020
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