Healthcare Provider Details

I. General information

NPI: 1528028560
Provider Name (Legal Business Name): RONALD JOE RUCKER NURSE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2006
Last Update Date: 07/13/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 WERNER ST
HOT SPRINGS AR
71913-6406
US

IV. Provider business mailing address

2120 SHADY LN
MALVERN AR
72104-6045
US

V. Phone/Fax

Practice location:
  • Phone: 501-622-1930
  • Fax: 501-622-2066
Mailing address:
  • Phone: 501-337-9604
  • Fax: 501-622-2066

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR34655
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: