Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 2013037311 | MO |
Y | 208600000X | Surgeon | 2013037311 | MO |
N | 208200000X | Surgeon | 2013037311 | MO |
N | 208600000X | Surgeon | 2013037311 | MO |
N | 2086S0105X | Surgery of the Hand | 2013037311 | MO |
NPI | 1750547352 |
---|---|
Provider Name | Dr. Donald William Buck II |
First Address | Alton, IL 62002-6723 |
Second Address | Alton, IL 62002-6723 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/08/2008 |
Last Update Date | 07/03/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
ENROLLED | (05) | IL |