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General NPI Number Information
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NPI Number | 1831695451
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Entity Type | Individual
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Provider Name | SEAN DONOVAN BUCK MD
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Gender | Male
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Dates
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Enumeration Date | 04/03/2018
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Last Update Date | 10/30/2025
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Provider Practice Location Address
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Address Line | 4602 E UNIVERSITY DR STE 150
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City | PHOENIX
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State | AZ
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Zip | 85034-7423
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Country | US
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Telephone | 480-588-0348
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Fax |
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Provider Business Mailing Address
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Address Line | 4602 E UNIVERSITY DR STE 150
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City | PHOENIX
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State | AZ
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Zip | 85034-7423
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Country | US
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Telephone |
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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 | 35C.001517
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | DR0062867
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | IMLC.MD.61552720
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License Number State | WA
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Taxonomy #4
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 73665
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License Number State | AZ
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Taxonomy #5
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | V0597
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License Number State | TX
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Taxonomy #6
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 45899
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License Number State | OK
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Taxonomy #7
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 25577
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License Number State | NV
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