Individual
MICHAEL GURDON BUCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1587 N BOLTON AVE, SUITE 1100, ALEXANDRIA, LA 71303-4217
(318) 473-4500
(318) 445-1509
Mailing address
1587 N BOLTON AVE, SUITE 1100, ALEXANDRIA, LA 71303-4217
(318) 473-4500
(318) 445-1509
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
015029
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1318469
—
LA
01
—
5J260
MEDICARE PTAN
—
Enumeration date
10/25/2005
Last updated
02/28/2017
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