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General NPI Number Information
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NPI Number | 1184626525
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Entity Type | Individual
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Provider Name | LEONARD JOSEPH BUCK MD
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Gender | Male
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Dates
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Enumeration Date | 08/15/2005
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Last Update Date | 05/12/2008
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Provider Practice Location Address
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Address Line | 1050 ISAAC STREETS DR SUITE 116
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City | OREGON
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State | OH
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Zip | 43616-3291
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Country | US
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Telephone | 419-698-2512
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Fax | 419-698-2004
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Provider Business Mailing Address
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Address Line | 1050 ISAAC STREETS DR SUITE 116
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City | OREGON
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State | OH
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Zip | 43616-3291
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Country | US
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Telephone | 419-698-2512
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Fax | 419-698-2004
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 35-04-4078 B
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License Number State | OH
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