Organization
RALPH H. RUCKLE, MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RALPH H. RUCKLE MD (OWNER)
(615) 325-7337
Entity
Organization
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
05
—
3160017
—
TN
Enumeration date
05/29/2007
Last updated
08/22/2020
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