Individual
KENNETH C. RICKLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
345 BLACKSTONE BLVD, PROVIDENCE, RI 02906-4800
(401) 455-6200
(401) 455-6309
Mailing address
345 BLACKSTONE BLVD, PROVIDENCE, RI 02906-4800
(401) 455-6200
(401) 455-6309
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
MD08987
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05-00163
UNITED HEALTHCARE
RI
01
—
1093831646
BUTLER HOSPITAL PROFESSIONAL BILLING OFFICE
RI
01
—
1104801349
BUTLER HOSPITAL NPI
RI
01
—
204792
BLUE CHIP
RI
01
—
25226-5
BLUE CROSS
RI
05
—
9025246
—
RI
Enumeration date
07/28/2006
Last updated
05/20/2008
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