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NPI Code Detail

MEDICARE: ERIC M. RUOCCO M.D.

MEDICARE: ERIC M. RUOCCO M.D.
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
1207L00000XAnesthesiology Physician101102MO
2207L00000XAnesthesiology Physician036.117725IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1457346082
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERIC M. RUOCCO M.D.
Provider Business Mailing Address
First Line : PO BOX 551
Second Line :
City : HANNIBAL
State : MO
Zip : 63401-0551
Country : US
Telephone Number : 573-248-5401
Fax Number : 573-248-5419
Provider Business Practice Location Address
First Line : 6000 HOSPITAL DR
Second Line :
City : HANNIBAL
State : MO
Zip : 63401-6887
Country : US
Telephone Number : 573-248-1300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/20/2005
Last Update Date : 04/08/2025

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