Organization
ELLESTON CRAIG RUCKER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELLESTON CRAIG RUCKER MD (OWNER)
(702) 439-5283
Entity
Organization
Contact information
Practice address
811 S DECATUR BLVD, LAS VEGAS, NV 89107-3933
(702) 439-5283
Mailing address
811 S DECATUR BLVD, LAS VEGAS, NV 89107-3933
(702) 439-5283
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
6766
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1679601470
—
NV
Enumeration date
04/16/2018
Last updated
04/16/2018
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