Individual
DR. RALPH H. RUCKLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
103 REDBUD DR, SUITE C, PORTLAND, TN 37148-1617
(615) 325-7337
(615) 325-0164
Mailing address
103 REDBUD DR, SUITE C, PORTLAND, TN 37148-1617
(615) 325-7337
(615) 325-0164
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD9576
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2000371
BCBS OF TENNESSEE
TN
Enumeration date
09/20/2005
Last updated
07/08/2007
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