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NPI Code Detail

MEDICARE: DR. KIRSTEN J BUCK M.D.

MEDICARE: DR. KIRSTEN J BUCK M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207L00000XAnesthesiology Physician50213WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1366447278
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KIRSTEN J BUCK M.D.
Provider Business Mailing Address
First Line : 339 CONSORT DR
Second Line :
City : BALLWIN
State : MO
Zip : 63011-4439
Country : US
Telephone Number : 636-386-9224
Fax Number : 636-386-7679
Provider Business Practice Location Address
First Line : 3003 UNIVERSITY DR
Second Line :
City : MARINETTE
State : WI
Zip : 54143-4110
Country : US
Telephone Number : 715-735-4200
Fax Number : 715-735-8019
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/16/2005
Last Update Date : 11/29/2021

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