Healthcare Provider Details

I. General information

NPI: 1609846427
Provider Name (Legal Business Name): ALEXANDRA N BUK DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/24/2006
Last Update Date: 12/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4200 N RODNEY PARHAM RD STE 100
LITTLE ROCK AR
72212-2458
US

IV. Provider business mailing address

4200 N RODNEY PARHAM RD STE 100
LITTLE ROCK AR
72212-2458
US

V. Phone/Fax

Practice location:
  • Phone: 501-534-8888
  • Fax: 501-534-8891
Mailing address:
  • Phone: 501-534-8888
  • Fax: 501-534-8891

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number153
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: