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General NPI Number Information
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NPI Number | 1225868896
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Entity Type | Individual
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Provider Name | TAKUR GEORGE BUCK M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/07/2024
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Last Update Date | 07/18/2025
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Provider Practice Location Address
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Address Line | PO BOX 457
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City | GANADO
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State | AZ
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Zip | 86505-0457
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Country | US
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Telephone | 928-755-4500
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Fax |
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Provider Business Mailing Address
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Address Line | 129 N WASHINGTON ST
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City | SUMTER
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State | SC
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Zip | 29150-4949
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Country | US
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Telephone | 517-980-9698
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Fax |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | LL94714
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License Number State | SC
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