Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 10197429-1204 | UT |
N | 208600000X | Surgeon | 10197429-1204 | UT |
N | 208200000X | Surgeon | 1871 | NE |
N | 208600000X | Surgeon | 1871 | NE |
Y | 208200000X | Surgeon | 34.013186 | OH |
Y | 208600000X | Surgeon | 34.013186 | OH |
N | 208200000X | Surgeon | BP10044527 | TX |
N | 208600000X | Surgeon | BP10044527 | TX |
N | 2086S0102X | Surgical Critical Care | 10197429-1204 | UT |
N | 2086S0102X | Surgical Critical Care | 34.013186 | OH |
N | 2086S0105X | Surgery of the Hand | 34.013186 | OH |
NPI | 1962825216 |
---|---|
Provider Name | Dr. Ronald A Buczek II |
First Address | Fort Worth, TX 76104-3902 |
Second Address | Dayton, OH 45402 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/01/2014 |
Last Update Date | 24/10/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0268501 | (05) | OH |
H594490 | MEDICARE (01) | OH |
H594491 | MEDICARE PTAN (01) | OH |
P02095690 | RRMEDICARE PTAN (01) | OH |