Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207ND0101X | MOHS-Micrographic Surgeon | 30380 | KY |
NPI | 1457355174 |
---|---|
Provider Name | Dr. John L Buker |
First Address | Lexington, KY 40509-2500 |
Second Address | Lexington, KY 40509-2500 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/06/2005 |
Last Update Date | 17/07/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000011970 | CHA PROVIDER NUMBER (01) | KY |
000000317646 | ANTHEM PROVIDER NUMBER (01) | KY |
0004122791 | AETNA PROVIDER NUMBER (01) | KY |