MEDICARE: RONALD PAUL LADUKE JR.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	10649	TN

General Provider Information

NPI Number	:	1053638908
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RONALD PAUL LADUKE JR.

Provider Business Mailing Address
First Line	:	1429 MARATHON DR
Second Line	:
City	:	MURFREESBORO
State	:	TN
Zip	:	37129-2605
Country	:	US
Telephone Number	:	615-944-9022
Fax Number	:

Provider Business Practice Location Address
First Line	:	305 SEABOARD LN
Second Line	:	SUITE 318
City	:	FRANKLIN
State	:	TN
Zip	:	37067-8287
Country	:	US
Telephone Number	:	615-771-8790
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/30/2010
Last Update Date	:	04/30/2010

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