Provider Demographics
NPI:1730462938
Name:RICKLES, NATHANIEL M (PHARMD, PHD)
Entity Type:Individual
Prefix:DR
First Name:NATHANIEL
Middle Name:M
Last Name:RICKLES
Suffix:
Gender:M
Credentials:PHARMD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 DOE DR
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:MA
Mailing Address - Zip Code:02038-3237
Mailing Address - Country:US
Mailing Address - Phone:508-346-3366
Mailing Address - Fax:
Practice Address - Street 1:9 DOE DR
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:MA
Practice Address - Zip Code:02038-3237
Practice Address - Country:US
Practice Address - Phone:508-346-3366
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-23
Last Update Date:2011-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA268821835P1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1300XPharmacy Service ProvidersPharmacistPsychiatric