Healthcare Provider Details

I. General information

NPI: 1437461613
Provider Name (Legal Business Name): LARISA C BUCK D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2010
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1215 DUFF AVE
AMES IA
50010-5469
US

IV. Provider business mailing address

1215 DUFF AVE
AMES IA
50010-5469
US

V. Phone/Fax

Practice location:
  • Phone: 515-239-4432
  • Fax: 515-239-4754
Mailing address:
  • Phone: 515-239-4418
  • Fax: 515-956-4170

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number6326
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberQ0882
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: