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General NPI Number Information
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NPI Number | 1437377397
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Entity Type | Individual
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Provider Name | GREGORY FRANKLIN BUCK PA-C
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Gender | Male
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Dates
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Enumeration Date | 04/23/2007
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Last Update Date | 10/08/2020
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Provider Practice Location Address
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Address Line | 96 JONATHAN LUCAS ST 210 CSB
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City | CHARLESTON
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State | SC
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Zip | 29425
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Country | US
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Telephone | 843-792-5622
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Fax | 843-792-1707
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Provider Business Mailing Address
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Address Line | 1051 LOYALIST LN
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City | MOUNT PLEASANT
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State | SC
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Zip | 29464-9235
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Country | US
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Telephone | 843-881-2039
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 501
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License Number State | SC
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