Organization
RUCKEL, INC.
Active
Other names
James S Ruckel DC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES S RUCKEL DC (DOCTOR OF CHIROPRACTIC)
(260) 436-5200
Entity
Organization
Contact information
Practice address
7313 W JEFFERSON BLVD, FORT WAYNE, IN 46804-6237
(260) 436-5200
(260) 436-1103
Mailing address
7313 W JEFFERSON BLVD, FORT WAYNE, IN 46804-6237
(260) 436-5200
(260) 436-1103
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
08001766
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000531878
ANTHEM BC/BS
IN
05
—
201041440
—
IN
01
—
350049797
MEDICARE RAILROAD
IN
Enumeration date
12/04/2007
Last updated
12/22/2011
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