Individual
MR. BRUCE W. RICKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
504 N. CLEVELAND ST., MOUNT AYR, IA 50854-2201
(641) 464-3226
(641) 464-4420
Mailing address
504 N. CLEVELAND ST., MOUNT AYR, IA 50854-2201
(641) 464-3226
(641) 464-4420
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
02962
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002962
—
SC
05
—
0139626
—
IA
05
—
080090856
—
IA
05
—
1139626
—
IA
05
—
245885116
—
MO
01
—
57934
BLUE CROSS
IA
01
—
8810
MIDLAND CHOICE
IA
05
—
930044754
—
IA
01
—
IA0110
JOHN DEERE
IA
Enumeration date
01/11/2007
Last updated
11/23/2009
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