Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 35056118 | OH |
N | 111NI0900X | Internist | 35056118 | OH |
Y | 207SG0201X | Clinical Genetics (M.D.) | 35056118 | OH |
NPI | 1831394675 |
---|---|
Provider Name | Donald Louis Rucknagel |
First Address | Cincinnati, OH 45206-1785 |
Second Address | Cincinnati, OH 45219-2364 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2007 |
Last Update Date | 25/10/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0372341 | (05) | OH |
200012580 | (05) | IN |
6486453100 | (05) | KY |
E70955 | (02) | OH |