Provider Demographics
NPI:1427122589
Name:DR. RICHARD F. BUCK LLC
Entity type:Organization
Organization Name:DR. RICHARD F. BUCK LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:F
Authorized Official - Last Name:BUCK
Authorized Official - Suffix:
Authorized Official - Credentials:CHIROPRACTOR
Authorized Official - Phone:419-474-1002
Mailing Address - Street 1:5606 SECOR RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43623-1935
Mailing Address - Country:US
Mailing Address - Phone:419-474-1002
Mailing Address - Fax:419-474-1002
Practice Address - Street 1:5606 SECOR RD
Practice Address - Street 2:SUITE A
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43623-1935
Practice Address - Country:US
Practice Address - Phone:419-474-1002
Practice Address - Fax:419-474-1002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-20
Last Update Date:2013-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHDC 1472111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH10169OtherPARAMOUNT
OH0746483Medicaid
OH13360559300OtherBWC
OH137712OtherANTHEM
OH10169OtherPARAMOUNT
OH13360559300OtherBWC
OH13360559300OtherBWC