Individual
PETER J BUECKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4331 CHURCHMAN AVE, SUITE 101, LOUISVILLE, KY 40215-1164
(502) 364-0902
(502) 364-0099
Mailing address
4331 CHURCHMAN AVE, SUITE 101, LOUISVILLE, KY 40215-1164
(502) 364-0902
(502) 364-0099
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
35801
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000995097
ANTHEM
—
01
—
50101088
PASSPORT HEALTH PLAN
KY
05
—
64104680
—
KY
01
—
7556710
AETNA PROVIDER NUMB
KY
01
—
P01572803
RAILROAD MEDICARE
KY
Enumeration date
04/26/2006
Last updated
03/25/2016
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