Individual
DR. MARK R. RUCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6642 WELLS CIRCLE, SPRINGDALE, AR 72762
(479) 409-7366
Mailing address
6642 WELLS CIRCLE, SPRINGDALE, AR 72762
(479) 409-7366
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
E-0609
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1315552001
—
AR
Enumeration date
05/13/2006
Last updated
03/16/2016
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