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NPI Code Detail

MEDICARE: JULIA RUTH BUCK MD

MEDICARE: JULIA RUTH BUCK MD
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
1390200000XStudent in an Organized Health Care Education/Training Program11020350AIN
2207Q00000XFamily Medicine Physician4301506269MI

General Provider Information

NPI Number : 1538725155
Entity Type Code : Individual
Provider Name (Legal Business Name) : JULIA RUTH BUCK MD
Provider Business Mailing Address
First Line : 601 JOHN STREET
Second Line : BOX 39
City : KALAMAZOO
State : MI
Zip : 49007
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2900 WATKINS RD
Second Line :
City : BATTLE CREEK
State : MI
Zip : 49015-8604
Country : US
Telephone Number : 269-245-5430
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/20/2019
Last Update Date : 07/14/2022

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